Leiden University Student Repository

Demir, Cara (2022)

Disease-Related Anxiety, Clinical Health Outcomes, and Health-Related Quality of Life in Patients with Cardiovascular Disease: A Systematic Review and Meta-Analysis

Master thesis | Psychology (MSc)

Cardiovascular Disease (CVD) constitutes the single leading cause of death and disability worldwide. Although mortality rates have been declining in recent decades, CVD still represents a severe threat to patients’ health and health-related quality of life (HRQoL). Patients who develop comorbid disease-related anxiety are at increased risk for worse disease progression and impaired HRQoL. The purpose of this paper was to review the current scientific evidence and to perform a meta-analysis on the relationship between disease-related anxiety and clinical health outcomes in patients with CVD. Due to an insufficient number of studies, our analysis focused on the relationship between cardiac anxiety and HRQoL. The literature was searched for eligible articles published by September 2021 on eight online databases. Data extraction revealed 12 observational studies eligible for inclusion in the systematic review. Of those, 4 articles (including 985 patients) fulfilled the criteria to be...Show moreCardiovascular Disease (CVD) constitutes the single leading cause of death and disability worldwide. Although mortality rates have been declining in recent decades, CVD still represents a severe threat to patients’ health and health-related quality of life (HRQoL). Patients who develop comorbid disease-related anxiety are at increased risk for worse disease progression and impaired HRQoL. The purpose of this paper was to review the current scientific evidence and to perform a meta-analysis on the relationship between disease-related anxiety and clinical health outcomes in patients with CVD. Due to an insufficient number of studies, our analysis focused on the relationship between cardiac anxiety and HRQoL. The literature was searched for eligible articles published by September 2021 on eight online databases. Data extraction revealed 12 observational studies eligible for inclusion in the systematic review. Of those, 4 articles (including 985 patients) fulfilled the criteria to be included in the meta-analyses, which examined the association between cardiac anxiety and both physical and mental HRQoL, respectively. Under the random-effects model, we found a significant and negative correlation between cardiac anxiety and physical HRQoL (r = -0.53: 95% CI [-0.57, -0.48; p < .001]). Additionally, we found a significant and negative correlation of small-to-moderate strength between cardiac anxiety and mental HRQoL (r = -0.43: 95% CI [-0.50, -0.35; p < .001]). These results implicate that, on average, patients with CVD experience lower levels of both physical and mental HRQoL with increasing levels of cardiac anxiety. Our findings further suggest that routine screenings should be implemented in clinical practice to identify and potentially treat at-risk patients. Future research on the cause-and-effect of these relationships is warranted.Show less

cardiovascular disease

disease-specific anxiety

cardiac anxiety

kinesiophobia

cardiac rehabilitation

Author

Demir, Cara

Faculty

Faculty of Social & Behavioural Sciences

Specialisation

Health and Medical Psychology

Supervisors

Reijnders, T.

ECTS Credits

20

Language

en