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This slides describe 5 studies which take a psychosocial perspective on individuals with coronary heart disease (CHD). The first was a validation study, concerned with necessary preparatory work, which used multiple sources of evidence to validate the Indonesian version of the Beck Depression Inventory-II (Indo BDI-II). The second study investigated associations between psychosocial risk factors of CHD, the third study investigated how spirituality is related to negative emotions. The fourth study explored the mechanism of attentional bias and anxiety. The fifth study was an intervention study which tested the effect of viewing a video on changing maladaptive beliefs about the disease, and reducing anxiety and depression.
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Psychosocial factors in individuals with coronary heart disease:
Cognitions, emotions, and health behaviors
Henndy Ginting
Public defenceNijmegen, 16 April 2014
A letter from Pramoedya Ananta Toer
“Saya sudah memberikan semuanya kepada Indonesia. Umur, kesehatan, masa muda sampai setua ini. Sekarang saya tidak bisa menulis-baca lagi. Dalam hitungan hari, minggu, atau bulan mungkin saya akan mati, karena penyempitan pembuluh darahjantung. Basa-basi tak lagi bisa menghibur saya.”
“I have given everything to Indonesia. Age, health, youth until this old age. Now,
I can not write-read any more. In a matter of days, weeks, or months perhaps I will die,
because the narrowing of coronary arteries. Pleasantries can no longer comfort me.”
Coronary heart disease (CHD)
Bad news:
Life threatening and stressful
life event (Byrne &
Rosenman, 1990).
CHD in Indonesia
CHD = 18% (2nd) cause of death.
(Hasnawaty et al., 2009; WHO,
2011).
10.8 million CHD patients
(Depkes RI, 2008).
Good news:
Improvement in risk factors
management and innovation in
cardiac medications reduce
mortality (e.g., Ford & Capewell,
2011; Hunink et al., 1997;
Zaman et al., 2008)
Psychosocial problems
Consequences as well as important risk factors of CHD (e.g., Yusuf et al., 2004; Zaman et al., 2008).
Anxiety Anger Depression
Perceived less social support
Unhealthy behaviors
We assessed (in individuals with CHD):
• Anxiety
• Depression
• Anger
• Social support
• Health behaviors
A video intervention program.
We proposed:
• Personality type
• Attentional bias
• Spirituality
• Maladaptive beliefs about the disease).
Measures adaptation
Indonesian version of the Beck Depression Inventory-II (the Indo BDI-II):
•Factorial similarity across groups
•Construct validity
•Discriminative power
•Reliability
•Cut-off point of 17 for mild depression
Distressed personality type (Type D)
1. Less healthy and 1. Less healthy and more unhealthy more unhealthy behaviors. behaviors.
2. Less perceived 2. Less perceived social support. social support.
Spirituality in individuals with CHDMeaningfulness Trust
Caring for others Spiritual activities
Acceptance
Connectedness with nature
Transcendent experiences
Connectedness with:•Self •Others/nature •Transcendent.
Anxiety Depression
Anger
Anxiety and attentional bias in CHD
Video information about CHD
CG: No videotape
Did not watch the video.
Watched the video only.
The video with opportunity to ask questions.
Increased adaptive beliefs about the disease
Decreased anxiety
Decreased Depression
General conclusion
• Type D personality, spirituality, attentional bias, and maladaptive beliefs are significant factors associated (positively or negatively) with psychosocial problems in CHD.
• There was a benefit of the video intervention.
• We suggested valid psychosocial measures (e.g., the Indo BDI-II).
Take home message
Consider and improve psychosocial diagnostics and interventions in Indonesian individuals with CHD.
Thank you for your attention
