![Page 1: Psychosocial factor in coronary heart disease](https://reader034.vdocuments.mx/reader034/viewer/2022052622/5594260d1a28ab3e768b473f/html5/thumbnails/1.jpg)
Psychosocial factors in individuals with coronary heart disease:
Cognitions, emotions, and health behaviors
Henndy Ginting
Public defenceNijmegen, 16 April 2014
![Page 2: Psychosocial factor in coronary heart disease](https://reader034.vdocuments.mx/reader034/viewer/2022052622/5594260d1a28ab3e768b473f/html5/thumbnails/2.jpg)
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.”
![Page 3: Psychosocial factor in coronary heart disease](https://reader034.vdocuments.mx/reader034/viewer/2022052622/5594260d1a28ab3e768b473f/html5/thumbnails/3.jpg)
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)
![Page 4: Psychosocial factor in coronary heart disease](https://reader034.vdocuments.mx/reader034/viewer/2022052622/5594260d1a28ab3e768b473f/html5/thumbnails/4.jpg)
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
![Page 5: Psychosocial factor in coronary heart disease](https://reader034.vdocuments.mx/reader034/viewer/2022052622/5594260d1a28ab3e768b473f/html5/thumbnails/5.jpg)
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).
![Page 6: Psychosocial factor in coronary heart disease](https://reader034.vdocuments.mx/reader034/viewer/2022052622/5594260d1a28ab3e768b473f/html5/thumbnails/6.jpg)
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
![Page 7: Psychosocial factor in coronary heart disease](https://reader034.vdocuments.mx/reader034/viewer/2022052622/5594260d1a28ab3e768b473f/html5/thumbnails/7.jpg)
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.
![Page 8: Psychosocial factor in coronary heart disease](https://reader034.vdocuments.mx/reader034/viewer/2022052622/5594260d1a28ab3e768b473f/html5/thumbnails/8.jpg)
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
![Page 9: Psychosocial factor in coronary heart disease](https://reader034.vdocuments.mx/reader034/viewer/2022052622/5594260d1a28ab3e768b473f/html5/thumbnails/9.jpg)
Anxiety and attentional bias in CHD
![Page 10: Psychosocial factor in coronary heart disease](https://reader034.vdocuments.mx/reader034/viewer/2022052622/5594260d1a28ab3e768b473f/html5/thumbnails/10.jpg)
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
![Page 11: Psychosocial factor in coronary heart disease](https://reader034.vdocuments.mx/reader034/viewer/2022052622/5594260d1a28ab3e768b473f/html5/thumbnails/11.jpg)
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).
![Page 12: Psychosocial factor in coronary heart disease](https://reader034.vdocuments.mx/reader034/viewer/2022052622/5594260d1a28ab3e768b473f/html5/thumbnails/12.jpg)
Take home message
Consider and improve psychosocial diagnostics and interventions in Indonesian individuals with CHD.
![Page 13: Psychosocial factor in coronary heart disease](https://reader034.vdocuments.mx/reader034/viewer/2022052622/5594260d1a28ab3e768b473f/html5/thumbnails/13.jpg)
Thank you for your attention