Outcomes of psychological interventions designed to change unhelpful illness perceptions in people with coronary heart disease (CHD): A Meta-analysis

Mika, Jadwiga (2016) Outcomes of psychological interventions designed to change unhelpful illness perceptions in people with coronary heart disease (CHD): A Meta-analysis. Doctoral thesis, University of East Anglia.

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Abstract

Background
Previous research demonstrated that maladaptive illness perceptions
contribute to poor psychological outcomes in CHD. Cardiac interventions are
effective in changing illness perceptions. However, it is unclear whether
interventions targeting illness perceptions can also contribute to positive changes
in symptoms of depression and anxiety. It is unclear whether interventions with
psychological components lead to more reduction in inaccurate illness
perceptions.
Objective
The current thesis aims to determine if psychological interventions are
more efficacious in changing illness perceptions compared to interventions
without these components. Another goal is to assess whether cardiac interventions
can also contribute to positive changes in anxiety and depression. Finally, the
present investigation assesses the impact of type of illness and age on the efficacy
of cardiac interventions.
Methods
Using meta-analytic design English databases, relevant journals and
references lists were searched for randomised controlled trials of interventions
designed to change illness perceptions. The outcomes included illness
perceptions, and symptoms of depression and anxiety.
Participants with CHD were included in the current meta-analysis. Effect sizes
were expressed as Hedges’s g.
Results
All cardiac interventions yield a small but consistent effect in reduction of
maladaptive illnesses perceptions. However, interventions with psychological
component are not significantly more efficacious in changing maladaptive illness
perception (Hedges’s g = .248) compared to interventions that do not contained
psychological components (Hedges’s g = .224). Interventions designed to change
illness perceptions contribute to significant positive change in symptoms of
anxiety (Hedges’s g = .204), but not symptoms of depression (Hedges’s g = -
.089). Participants with chronic illness report larger reduction in inaccurate illness
representations compared to participants with acute illness.
Conclusions
All components (psychological and non-psychological) of cardiac
interventions can lead to small but positive reduction in maladaptive illness
perceptions and symptoms of anxiety. While some interventions components (e.g.
information giving) might work on the cognitive level, other techniques (e.g.
active listening) might be more efficacious in addressing issues in emotional
processing of CHD. Further, depressive symptoms and acute nature of illness
might complicate process of change because of higher levels of emotional
distress.

Item Type: Thesis (Doctoral)
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User: Jackie Webb
Date Deposited: 19 Oct 2016 10:27
Last Modified: 19 Oct 2016 10:27
URI: https://ueaeprints.uea.ac.uk/id/eprint/60988
DOI:

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