Emotion Regulation and Perceptions of Illness Coherence and Controllability on Regimen Adherence and Negative Cardiac Health Events in African American Women With Heart Failure.
Kelly L Wierenga
PMID 28398917WHAT IT FOUND
No emotion-regulation or illness-understanding scores were associated with adherence or cardiac events in African American women with heart failure; only worse symptom class was associated with urgent care use.
Key findings
01The model testing emotion regulation, illness controllability, illness coherence, age, and education as predictors of general adherence was not significant (p = .434), and no individual predictor relationship was significant.
02The model predicting first emergency healthcare use was not significant (p = .140); the one significant predictor was heart failure symptom class (NYHA), associated with emergent healthcare services (β = 1.47, p = .027).
03Over the 90-day follow-up period, 28 participants (48%) had a negative health event; first events included 15 hospital admissions, six emergency department visits, and seven urgent visits, and time to event averaged 40.9 ± 25.6 days.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The sample was small, with 58 recruited, 54 completing intake, and 51 completing follow-up and medical record review. Follow-up was short, and events between 30 and 90 days were captured only from participating health systems. Adherence was self-reported, and the MOS-SAS was modified for this sample. The DERS was reduced from 36 items to 18 items, and the IPQ-R controllability items were combined after factor analysis. Illness duration varied, so distress could relate to a new diagnosis or to advancing disease. The study is correlational, so it cannot show that emotion regulation or illness perceptions cause adherence problems or cardiac events. Patients may have used informal care or facilities outside the participating health systems, so events could be undercounted.
Declared interests
The supplied text does not report funding sources or author conflict-of-interest statements.
The easy way to misread this
Do not conclude that emotion regulation and illness coherence are irrelevant to heart failure management. This small study did not find significant prediction, and weak trends reported by the authors are not evidence of an effect.