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1. Work environment, volume of activity and staffing in neonatal intensive care units in Italy: results of the SONAR-nurse study

Author

Corchia, C, Fanelli, S, Gagliardi, L, Bellù, R, Zangrandi, A, Persico, A, Zanini, R, SONAR-Nurse Study Group including Bellù, R, Bertino, E, Casati, M, Cazzaniga, A, Plevani, L, Mosca, F, Baracchetti, R, Villa, E, Tandoi, F, Boccacci, S, Martinelli, S, Coscia, P, Poggiani, C, Ferrari, D, Barera, G, Poloniato, A, Ruggeri, V, Burgio, G, Carrera, G, D'Alterio, R, Merazzi, D, Lomazzi, M, Coscia, A, Borgione, S, Anselmo, C, Galletto, P, Gancia, Gp, Parola, A, Sabatini, M, Gazzolo, D, Carli, G, Filippone, M, Lago, P, Heun, N, Visentin, S, Bertolini, A, Padovani, Em, Bellettato, M, Gasparin, B, Serra, A, Santuz, P, Ellero, S, Fantini, M, Contiero, Rm, Gallo, C, Mammoliti, Pm, Ancora, G, Faldella, G, Sandri, F, Stella, M, Biasini, A, Fioravanti, L, Dessì, S, Sigali, E, Vuerich, M, Cacciavellani, R, Bragetti, P, De Curtis, M, Lucchini, R, Parente, G, Massenzi, L, Calibita, G, Haass, C, Scapillati, E, Pietro, S, Dotta, A, D'Agostino, G, Picone, S, Messina, F, Napolitano, M, Salvia, G, Moschella, S, Orfeo, L, Chello, G, Carpentieri, M, Vacchiano, T, Vetrano, G, Rabuano, R, Simonetti, Dm, Quartulli, L, Rinaldi, M, Magaldi, R, Presta, G, Greco, F, Forziati, V, Acito, A, Gatta, A, Quitadamo, P, Rotondo, S, Laforgia, N, Grassi, A, Del Cuore, F, Lucente, M, Costabile, Cd, Nicolò, A, Arco, A, Marseglia, L, Pinna, G, Rosella, V, Giuffrè, M, Marchesano, G, Inferiore, N, Corso, G, Cannuscio, A, Gargano, G, Pedoni, S, Poloni, G, Di Leo, L, Crescenzi, F, Celi, F, Betta, P, Carlo Corchia, Simone Fanelli, Luigi Gagliardi, Roberto Bellù, Antonello Zangrandi, Anna Persico, Rinaldo Zanini, SONAR-Nurse Study GroupCorchia [.., Giacomo Faldella, ], Corchia, C., Fanelli, S., Gagliardi, L., Bellù, R., Zangrandi, A., Persico, A., Zanini, R., Giuffre, M., and SONAR-Nurse Study Group

Subjects
Cross-sectional study, Staffing, Workload, Critical Care Nursing, Pediatrics, 03 medical and health sciences, 0302 clinical medicine, Settore MED/38 - Pediatria Generale E Specialistica, Nursing, 030225 pediatrics, Intensive care, Critical care nursing, Surveys and Questionnaires, Neonatal, Intensive Care Units, Neonatal, Medicine, Humans, Surveys and Questionnaire, 030212 general & internal medicine, Location, Workplace, Cross-Sectional Studie, business.industry, Research, Nurse-Patient Relation, Infant, Newborn, Patient Acuity, Infant, Perinatology and Child Health, Newborn, Nurse-Patient Relations, Cross-Sectional Studies, Italy, Pediatric Nursing, Intensive Care Units, Workforce, Intensive care units, Nurse-patient relations, Patient acuity, Pediatrics, Perinatology and Child Health, Pediatric nursing, business, Human
Abstract

Background Neonatal units’ volume of activity, and other quantitative and qualitative variables, such as staffing, workload, work environment, care organization and geographical location, may influence the outcome of high risk newborns. Data about the distribution of these variables and their relationships among Italian neonatal units are lacking. Methods Between March 2010-April 2011, 63 neonatal intensive care units adhering to the Italian Neonatal Network participated in the SONAR Nurse study. Their main features and work environment were investigated by questionnaires compiled by the chief and by physicians and nurses of each unit. Twelve cross-sectional monthly-repeated surveys on different shifts were performed, collecting data on number of nurses on duty and number and acuity of hospitalized infants. Results Six hundred forty five physicians and 1601 nurses compiled the questionnaires. In the cross-sectional surveys 702 reports were collected, with 11082 infant and 3226 nurse data points. A high variability was found for units’ size (4–50 total beds), daily number of patients (median 14.5, range 3.4-48.7), number of nurses per shift (median 4.2, range 0.7-10.8) and number of team meetings per month. Northern regions performed better than Central and Southern regions for frequency of training meetings, qualitative assessment of performance, motivation within the unit and nursing work environment; mean physicians’ and nurses’ age increased moving from North to South. After stratification by terciles of the mean daily number of patients, the median number of nurses per shift increased at increasing volume of activity, while the opposite was found for the nurse-to-patient ratio adjusted by patients’ acuity. On average, in units belonging to the lower tercile there was 1 nurse every 2.5 patients, while in those belonging to the higher tercile the ratio was 1 nurse every 5 patients. Conclusions In Italy, there is a high variability in organizational characteristics and work environment among neonatal units and an uneven distribution of human resources in relation to volume of activity, suggesting that the larger the unit the greater the workload for each nurse. Urgent modifications in planning and organization of services are needed in order to pursue more efficient, homogeneous and integrated regionalized neonatal care systems.

Published
2016

2. [Quality of life, depression and cognitive functions 1. Operational protocol and its implementation]

Author

Rete Infermieri GISSI HF, Di Giulio P, Pera C, Scarano M, Ferri B, Lepore V, Miani D, Tognoni G, Rosson V, Serafini C, Zumino T, Partemi L, Falleroni ML, Moretti L, Porta L, Santorsola A, Tenerelli T, Bertoncelli B, Mengoli G, Stagnitto M, Puddu GM, Masini E, Pasini A, Boni S, Valsesia E, Cornacini G, Melis D, Mulina A, Giurlanda A, Fava M, Bellini P, Vallucci S, Cuomo A, Campanale S, Monatti G, Bianco T, Milli V, Antonelli L, Fanin L, Faiola L, Stefanizzi R, Mariani M, Rossi A, Regnani T, Loreni F, Cianfrocca R, Pisani A, Faraolfi V, Ponzalli P, Savli T, Cresci M, Guardalben S, Belluzzo B, Ruberti R, Zizzi M, Tonda C, Cadrobbi MG, Gilardi R, Mondì A, Costa A, Milan S, Zottarelli A, Parodi B, Sartorio N, Rossin B, Santi A, Cagnan P, Maradei E, Cauteruccio A, Carpino C, Addeo R, Izzo A, Amendola G, Prizzitano AM, Piluso GM, Iadevaio AL, Cinà MT, Cirrincione V, Gumina S, Codato G, Raimondo F, Capiello MG, Creta F, Barbieri M, Chiarella L, Abbondio L, Piccin M, Spillone V, Cutrupi G, Ruggeri A, Sicilia G, Provengano A, Marcari P, Ricci S, Pazzagli E, La Grotteria M, Orsini R, Leandri L, Vetere NA, Braggion E, Giordanino S, Armando S, Zampieri E, Danese MC, Valentini A, Ferrante MG, Santacroce C, Crocetti I, Macchi F, Bernacchi M, Pini D, Varì M, Lucente M, Scaramastra F, Reichardt S, Gabasio S, Zocchi C, Studhika M, Budzowska E, Cescon M, Lazzari D, Prizzon A, Di Biaggio P, Buda C, Mastrangelo V, Avigliano M, Dell'Aquila L, Bonanomi E, Mezzani A, Porcini F, Girardi G., PERRONE FILARDI, PASQUALE, Rete Infermieri GISSI, Hf, Di Giulio, P, Pera, C, Scarano, M, Ferri, B, Lepore, V, Miani, D, Tognoni, G, Rosson, V, Serafini, C, Zumino, T, Partemi, L, Falleroni, Ml, Moretti, L, Porta, L, Santorsola, A, Tenerelli, T, Bertoncelli, B, Mengoli, G, Stagnitto, M, Puddu, Gm, Masini, E, Pasini, A, Boni, S, Valsesia, E, Cornacini, G, Melis, D, Mulina, A, Giurlanda, A, Fava, M, Bellini, P, Vallucci, S, Cuomo, A, Campanale, S, Monatti, G, Bianco, T, Milli, V, Antonelli, L, Fanin, L, Faiola, L, Stefanizzi, R, Mariani, M, Rossi, A, Regnani, T, Loreni, F, Cianfrocca, R, Pisani, A, Faraolfi, V, Ponzalli, P, Savli, T, Cresci, M, Guardalben, S, Belluzzo, B, Ruberti, R, Zizzi, M, Tonda, C, Cadrobbi, Mg, Gilardi, R, Mondì, A, Costa, A, Milan, S, Zottarelli, A, Parodi, B, Sartorio, N, Rossin, B, Santi, A, Cagnan, P, Maradei, E, Cauteruccio, A, Carpino, C, Addeo, R, Izzo, A, Amendola, G, PERRONE FILARDI, Pasquale, Prizzitano, Am, Piluso, Gm, Iadevaio, Al, Cinà, Mt, Cirrincione, V, Gumina, S, Codato, G, Raimondo, F, Capiello, Mg, Creta, F, Barbieri, M, Chiarella, L, Abbondio, L, Piccin, M, Spillone, V, Cutrupi, G, Ruggeri, A, Sicilia, G, Provengano, A, Marcari, P, Ricci, S, Pazzagli, E, La Grotteria, M, Orsini, R, Leandri, L, Vetere, Na, Braggion, E, Giordanino, S, Armando, S, Zampieri, E, Danese, Mc, Valentini, A, Ferrante, Mg, Santacroce, C, Crocetti, I, Macchi, F, Bernacchi, M, Pini, D, Varì, M, Lucente, M, Scaramastra, F, Reichardt, S, Gabasio, S, Zocchi, C, Studhika, M, Budzowska, E, Cescon, M, Lazzari, D, Prizzon, A, Di Biaggio, P, Buda, C, Mastrangelo, V, Avigliano, M, Dell'Aquila, L, Bonanomi, E, Mezzani, A, Porcini, F, and Girardi, G.

Subjects
Time Factors, Depression, Cardiology, Prognosis, Nursing Research, Cognition, Clinical Protocols, Italy, Data Interpretation, Statistical, Surveys and Questionnaires, Quality of Life, Humans, Cardiomyopathies, Geriatric Assessment, Aged, Randomized Controlled Trials as Topic
Abstract

The QDF (Quality of life, Depression and cognitive Function) is a project elaborated and implemented by a Research Network of the nursing personnel of the cardiological services which promoted and run the GISSI-HF trial. It is a "companion study" which included up to 1/3 of all the GISSI-HF centres.To describe the distribution and evaluation of QDF variables measured with standardised instruments (Kansas City Cardiomiopathy Quality of Life questionnaire, KCCQ; Geriaric Depression scale GDS, Mini Mental State Examination MMSE), to verify whether and how far their knowledge could influence clinical decisions; to assess the prognostic impact of QDF values measured at entrance on mortality and morbidity. The study protocol included also a comprehensive evaluation of QDF variables independent from the questionnaires, by the nurses in charge of the study patients (the results of this part of the protocol are not included in this report).The QDF data were collected at baseline, 6 months, 1, 2 and 3 years through two self administered questionnaires (KCCQ, GDS), while the MMSE only for patients70 years. The questionnaires were administered to the patients who accepted to participate. A specific goal of the project focuses on the degree of independence between the results of the questionnaires and the judgement of the nurses. This contribution presents the operational implementation of the study protocol and general framework.

Published
2009

3. [Quality of life, depression and cognitive functions 2. Methodological aspects and data quality]

Author

Rete Infermieri GISSI HF, Di Giulio P, Pera C, Scarano M, Ferri B, Lepore V, Miani D, Tognoni G, Rosson V, Serafini C, Zumino MT, Partemi L, Falleroni ML, Moretti L, Porta L, Santorsola A, Tenerelli T, Bertoncelli B, Mengoli G, Stagnitto M, Puddu GM, Masini E, Pasini A, Boni S, Valsesia E, Cornacini G, Melis D, Mulina A, Giurlanda A, Fava M, Bellini P, Vallucci S, Cuomo A, Campanale S, Monatti G, Bianco T, Milli V, Antonelli L, Fanin L, Faiola L, Stefanizzi R, Mariani M, Rossi A, Regnani ST, Loreni F, Cianfrocca R, Pisani A, Faraolfi V, Ponzalli P, Savli T, Cresci M, Guardalben S, Belluzzo B, Ruberti R, Zizzi M, Tonda C, Cadrobbi MG, Gilardi R, Mondì A, Costa A, Milan S, Zottarelli A, Parodi B, Sartorio N, Rossin B, Santi A, Cagnan P, Maradei E, Cauteruccio A, Carpino C, Addeo R, Izzo A, Amendola G, Prizzitano AM, Piluso GM, Iadevaio AL, Cinà MT, Cirrincione V, Gumina S, Codato G, Raimondo F, Capiello MG, Creta F, Barbieri M, Chiarella L, Abbondio L, Piccin M, Spillone V, Cutrupi G, Ruggeri A, Sicilia G, Provengano A, Marcari P, Ricci S, Pazzagli E, La Grotteria M, Orsini R, Leandri L, Vetere NA, Braggion E, Giordanino S, Armando S, Zampieri E, Danese MC, Valentini A, Ferrante MG, Santacroce C, Crocetti I, Macchi F, Bernacchi M, Pini D, Varì M, Lucente M, Scaramastra F, Reichardt S, Gabasio S, Zocchi C, Studhika M, Budzowska E, Cescon M, Lazzari D, Prizzon A, Di Biaggio P, Buda C, Mastrangelo V, Avigliano M, Dell'Aquila L, Bonanomi E, Mezzani A, Porcini F, Girardi G., PERRONE FILARDI, PASQUALE, Rete Infermieri GISSI, Hf, Di Giulio, P, Pera, C, Scarano, M, Ferri, B, Lepore, V, Miani, D, Tognoni, G, Rosson, V, Serafini, C, Zumino, Mt, Partemi, L, Falleroni, Ml, Moretti, L, Porta, L, Santorsola, A, Tenerelli, T, Bertoncelli, B, Mengoli, G, Stagnitto, M, Puddu, Gm, Masini, E, Pasini, A, Boni, S, Valsesia, E, Cornacini, G, Melis, D, Mulina, A, Giurlanda, A, Fava, M, Bellini, P, Vallucci, S, Cuomo, A, Campanale, S, Monatti, G, Bianco, T, Milli, V, Antonelli, L, Fanin, L, Faiola, L, Stefanizzi, R, Mariani, M, Rossi, A, Regnani, St, Loreni, F, Cianfrocca, R, Pisani, A, Faraolfi, V, Ponzalli, P, Savli, T, Cresci, M, Guardalben, S, Belluzzo, B, Ruberti, R, Zizzi, M, Tonda, C, Cadrobbi, Mg, Gilardi, R, Mondì, A, Costa, A, Milan, S, Zottarelli, A, Parodi, B, Sartorio, N, Rossin, B, Santi, A, Cagnan, P, Maradei, E, Cauteruccio, A, Carpino, C, Addeo, R, Izzo, A, Amendola, G, PERRONE FILARDI, Pasquale, Prizzitano, Am, Piluso, Gm, Iadevaio, Al, Cinà, Mt, Cirrincione, V, Gumina, S, Codato, G, Raimondo, F, Capiello, Mg, Creta, F, Barbieri, M, Chiarella, L, Abbondio, L, Piccin, M, Spillone, V, Cutrupi, G, Ruggeri, A, Sicilia, G, Provengano, A, Marcari, P, Ricci, S, Pazzagli, E, La Grotteria, M, Orsini, R, Leandri, L, Vetere, Na, Braggion, E, Giordanino, S, Armando, S, Zampieri, E, Danese, Mc, Valentini, A, Ferrante, Mg, Santacroce, C, Crocetti, I, Macchi, F, Bernacchi, M, Pini, D, Varì, M, Lucente, M, Scaramastra, F, Reichardt, S, Gabasio, S, Zocchi, C, Studhika, M, Budzowska, E, Cescon, M, Lazzari, D, Prizzon, A, Di Biaggio, P, Buda, C, Mastrangelo, V, Avigliano, M, Dell'Aquila, L, Bonanomi, E, Mezzani, A, Porcini, F, and Girardi, G.

Subjects
Depression, Patient Selection, Cardiology, Middle Aged, Prognosis, Nursing Research, Cognition, Italy, Surveys and Questionnaires, Quality of Life, Humans, Multicenter Studies as Topic, Cardiomyopathies, Geriatric Assessment, Aged, Randomized Controlled Trials as Topic
Abstract

To document the degree of reliability of validated and mainly qualitative questionnaires most often used in research settings and/or projects, in a broad network of unselected cardiological centres; to assess whether the quality of data could be compatible with their use not only as descriptive but also in prognostic scores including mainly "hard" clinical variables.Eighty-three patients were included. Compliance with the self-administration of the Kansas City Cardiomiopathy Questionnaire (KCCQ) and the Geriatric Depression Scale (GDS) was very high throughout the study (KCCQ 97.7% baseline and 85.8% at three years). As expected more difficulties were encountered with the Mini Mental State Examination (administered to 80.6% patients baseline and to 54.3% at three years). Main reasons for not administering questionnaires was ascribed to organizational and patients problems.It is worth noticing that the study was conducted by nurses without economical incentives. The questionnaires were well completed with minimal missing data. If questionnaires are well presented to patients, a routine assessment of quality of life and depression could be feasible in everyday care.

Published
2009

4. [Quality of life, depression and cognitive functions 4. Quality of life]

Author

Rete Infermieri GISSI HF, Di Giulio P, Pera C, Scarano M, Ferri B, Lepore V, Miani D, Tognoni G, Rosson V, Serafini C, Zumino MT, Partemi L, Falleroni ML, Moretti L, Porta L, Santorsola A, Tenerelli T, Bertoncelli B, Mengoli G, Stagnitto M, Puddu GM, Masini E, Pasini A, Boni S, Valsesia E, Cornacini G, Melis D, Mulina A, Giurlanda A, Fava M, Bellini P, Vallucci S, Cuomo A, Campanale S, Monatti G, Bianco T, Milli V, Antonelli L, Fanin L, Faiola L, Stefanizzi R, Mariani M, Rossi A, Regnani ST, Loreni F, Cianfrocca R, Pisani A, Faraolfi V, Ponzalli P, Savli T, Cresci M, Guardalben S, Belluzzo B, Ruberti R, Zizzi M, Tonda C, Cadrobbi MG, Gilardi R, Mondì A, Costa A, Milan S, Zottarelli A, Parodi B, Sartorio N, Rossin B, Santi A, Cagnan P, Maradei E, Cauteruccio A, Carpino C, Addeo R, Izzo A, Amendola G, Prizzitano AM, Piluso GM, Iadevaio AL, Cinà MT, Cirrincione V, Gumina S, Codato G, Raimondo F, Capiello MG, Creta F, Barbieri M, Chiarella L, Abbondio L, Piccin M, Spillone V, Cutrupi G, Ruggeri A, Sicilia G, Provengano A, Marcari P, Ricci S, Pazzagli E, La Grotteria M, Orsini R, Leandri L, Vetere NA, Braggion E, Giordanino S, Armando S, Zampieri E, Danese MC, Valentini A, Ferrante MG, Santacroce C, Crocetti I, Macchi F, Bernacchi M, Pini D, Varì M, Lucente M, Scaramastra F, Reichardt S, Gabasio S, Zocchi C, Studhika M, Budzowska E, Cescon M, Lazzari D, Prizzon A, Di Baggio P, Buda C, Mastrangelo V, Avigliano M, Dell'Aquila L, Bonanomi E, Mezzani A, Porcini F, Girardi G., PERRONE FILARDI, PASQUALE, Rete Infermieri GISSI, Hf, Di Giulio, P, Pera, C, Scarano, M, Ferri, B, Lepore, V, Miani, D, Tognoni, G, Rosson, V, Serafini, C, Zumino, Mt, Partemi, L, Falleroni, Ml, Moretti, L, Porta, L, Santorsola, A, Tenerelli, T, Bertoncelli, B, Mengoli, G, Stagnitto, M, Puddu, Gm, Masini, E, Pasini, A, Boni, S, Valsesia, E, Cornacini, G, Melis, D, Mulina, A, Giurlanda, A, Fava, M, Bellini, P, Vallucci, S, Cuomo, A, Campanale, S, Monatti, G, Bianco, T, Milli, V, Antonelli, L, Fanin, L, Faiola, L, Stefanizzi, R, Mariani, M, Rossi, A, Regnani, St, Loreni, F, Cianfrocca, R, Pisani, A, Faraolfi, V, Ponzalli, P, Savli, T, Cresci, M, Guardalben, S, Belluzzo, B, Ruberti, R, Zizzi, M, Tonda, C, Cadrobbi, Mg, Gilardi, R, Mondì, A, Costa, A, Milan, S, Zottarelli, A, Parodi, B, Sartorio, N, Rossin, B, Santi, A, Cagnan, P, Maradei, E, Cauteruccio, A, Carpino, C, Addeo, R, Izzo, A, Amendola, G, PERRONE FILARDI, Pasquale, Prizzitano, Am, Piluso, Gm, Iadevaio, Al, Cinà, Mt, Cirrincione, V, Gumina, S, Codato, G, Raimondo, F, Capiello, Mg, Creta, F, Barbieri, M, Chiarella, L, Abbondio, L, Piccin, M, Spillone, V, Cutrupi, G, Ruggeri, A, Sicilia, G, Provengano, A, Marcari, P, Ricci, S, Pazzagli, E, La Grotteria, M, Orsini, R, Leandri, L, Vetere, Na, Braggion, E, Giordanino, S, Armando, S, Zampieri, E, Danese, Mc, Valentini, A, Ferrante, Mg, Santacroce, C, Crocetti, I, Macchi, F, Bernacchi, M, Pini, D, Varì, M, Lucente, M, Scaramastra, F, Reichardt, S, Gabasio, S, Zocchi, C, Studhika, M, Budzowska, E, Cescon, M, Lazzari, D, Prizzon, A, Di Baggio, P, Buda, C, Mastrangelo, V, Avigliano, M, Dell'Aquila, L, Bonanomi, E, Mezzani, A, Porcini, F, and Girardi, G.

Subjects
Male, Depression, Cardiology, Prognosis, Hospitalization, Nursing Research, Cognition, Italy, Risk Factors, Data Interpretation, Statistical, Surveys and Questionnaires, Quality of Life, Humans, Female, Mortality, Cardiomyopathies, Aged, Randomized Controlled Trials as Topic
Abstract

Aim of this paper is to explore and quanti-quantitatively assess whether QoL as measured with the Kansas City Cardiomiopathy Questionnaire (KCCQ) summary score could be considered as an independent relevant component of clinical prognostic score of morbidity and mortality and identify patients at risk for death or admissions.Sixty-three per cent NYHA II and 39.4% NYHA III-IV patients experience a good Qol (score75). Risk factors for "not good" (75) QoL are age, NYHA class III-IV, diabetes, COPD and previous hospitalizations. NYHA II and III-IV patients with not good QoL experience an higher mortality than patients with a good QoL in the same classes. NYHA II patients with not good QoL experience the same 1 year readmission rates as NYHA III-IV patients with good QoL.Quality of life scores identify patients with different risk of mortality and readmissions within the same NYHA class. The prognostic value of KCCQ summary scores could identify candidates for disease management in whom better targeted care strategies may reduce hospitalizations and prevent deaths.

Published
2009

5. [Quality of life, depression and cognitive functions 3. The main characteristics of the QDF study population]

Author

Rete Infermieri GISSI HF, Di Giulio P, Pera C, Scarano M, Ferri B, Lepore V, Miani D, Tognoni G, Rosson V, Serafini C, Zumino MT, Partemi L, Falleroni ML, Moretti L, Porta L, Santorsola A, Tenerelli T, Bertoncelli B, Mengoli G, Stagnitto M, Puddu GM, Masini E, Pasini A, Boni S, Valsesia E, Cornacini G, Melis D, Mulina A, Giurlanda A, Fava M, Bellini P, Vallucci S, Cuomo A, Campanale S, Monatti G, Bianco T, Milli V, Antonelli L, Fanin L, Faiola L, Stefanizzi R, Mariani M, Rossi A, Regnani ST, Loreni F, Cianfrocca R, Pisani A, Faraolfi V, Ponzalli P, Savli T, Cresci M, Guardalben S, Belluzzo B, Ruberti R, Zizzi M, Tonda C, Cadrobbi MG, Gilardi R, Mondì A, Costa A, Milan S, Zottarelli A, Parodi B, Sartorio N, Rossin B, Santi A, Cagnan P, Maradei E, Cauteruccio A, Carpino C, Addeo R, Izzo A, Amendola G, Prizzitano AM, Piluso GM, Iadevaio AL, Cinà MT, Cirrincione V, Gumina S, Codato G, Raimondo F, Cappiello MG, Creta F, Barbieri M, Chiarella L, Abbondio L, Piccin M, Spillone V, Cutrupi G, Ruggeri A, Sicilia G, Provengano A, Marcari P, Ricci S, Pazzagli E, La Grotteria M, Orsini R, Leandri L, Vetere NA, Braggion E, Giordanino S, Armando S, Zampieri E, Danese MC, Valentini A, Ferrante MG, Santacroce C, Crocetti I, Macchi F, Bernacchi M, Pini D, Varì M, Lucente M, Scaramastra F, Reichardt S, Gabasio S, Zocchi C, Studhika M, Budzowska E, Cescon M, Lazzari D, Prizzon A, Di Biaggio P, Buda C, Mastrangelo V, Avigliano M, Dell'Aquila L, Bonanomi E, Mezzani A, Porcini F, Girardi G., PERRONE FILARDI, PASQUALE, Rete Infermieri GISSI, Hf, Di Giulio, P, Pera, C, Scarano, M, Ferri, B, Lepore, V, Miani, D, Tognoni, G, Rosson, V, Serafini, C, Zumino, Mt, Partemi, L, Falleroni, Ml, Moretti, L, Porta, L, Santorsola, A, Tenerelli, T, Bertoncelli, B, Mengoli, G, Stagnitto, M, Puddu, Gm, Masini, E, Pasini, A, Boni, S, Valsesia, E, Cornacini, G, Melis, D, Mulina, A, Giurlanda, A, Fava, M, Bellini, P, Vallucci, S, Cuomo, A, Campanale, S, Monatti, G, Bianco, T, Milli, V, Antonelli, L, Fanin, L, Faiola, L, Stefanizzi, R, Mariani, M, Rossi, A, Regnani, St, Loreni, F, Cianfrocca, R, Pisani, A, Faraolfi, V, Ponzalli, P, Savli, T, Cresci, M, Guardalben, S, Belluzzo, B, Ruberti, R, Zizzi, M, Tonda, C, Cadrobbi, Mg, Gilardi, R, Mondì, A, Costa, A, Milan, S, Zottarelli, A, Parodi, B, Sartorio, N, Rossin, B, Santi, A, Cagnan, P, Maradei, E, Cauteruccio, A, Carpino, C, Addeo, R, Izzo, A, Amendola, G, PERRONE FILARDI, Pasquale, Prizzitano, Am, Piluso, Gm, Iadevaio, Al, Cinà, Mt, Cirrincione, V, Gumina, S, Codato, G, Raimondo, F, Cappiello, Mg, Creta, F, Barbieri, M, Chiarella, L, Abbondio, L, Piccin, M, Spillone, V, Cutrupi, G, Ruggeri, A, Sicilia, G, Provengano, A, Marcari, P, Ricci, S, Pazzagli, E, La Grotteria, M, Orsini, R, Leandri, L, Vetere, Na, Braggion, E, Giordanino, S, Armando, S, Zampieri, E, Danese, Mc, Valentini, A, Ferrante, Mg, Santacroce, C, Crocetti, I, Macchi, F, Bernacchi, M, Pini, D, Varì, M, Lucente, M, Scaramastra, F, Reichardt, S, Gabasio, S, Zocchi, C, Studhika, M, Budzowska, E, Cescon, M, Lazzari, D, Prizzon, A, Di Biaggio, P, Buda, C, Mastrangelo, V, Avigliano, M, Dell'Aquila, L, Bonanomi, E, Mezzani, A, Porcini, F, and Girardi, G.

Subjects
Aged, 80 and over, Male, Depression, Age Factors, Cardiology, Prognosis, Education, Nursing Research, Cognition, Sex Factors, Italy, Surveys and Questionnaires, Quality of Life, Humans, Female, Cardiomyopathies, Aged, Randomized Controlled Trials as Topic
Abstract

This contribution describes the patients included for the QDF (Quality of life, Depression and Cognitive functions) study and explores the distribution and time trends of scores of the three dimensions.The large majority of patients are males (78.3%), and mean age is 67.2 +/- 10.7 years (9.2%80 years). Patients in NYHA class III-IV experience more depression and a worse QoL as compared to the less severly clinically affected counterparts in NYHA class. Although QoL and depression are influenced by the same variables, not all patients with bad QoL are depressed and viceversa. Mean scores of cognitive functioning are not influenced by the same variables that influence QoL and depression.The regular measurement of QoL, depression and cognitive function is recommended by some authors. It seems to be confirmed that the three dimensions need to be explored to disentangle the specific informative value that each of them could add to clinical measures.

Published
2009

6. [Quality of life, depression and cognitive functions 6. Cognitive functions]

Author

Rete Infermieri GISSI HF, Di Giulio P, Pera C, Scarano M, Ferri B, Lepore V, Miani D, Tognoni G, Rosson V, Serafini C, Zumino MT, Partemi L, Falleroni ML, Moretti L, Porta L, Santorsola A, Tenerelli T, Bertoncelli B, Mengoli G, Stagnitto M, Puddu GM, Masini E, Pasini A, Boni S, Valsesia E, Cornacini G, Melis D, Mulina A, Giurlanda A, Fava M, Bellini P, Vallucci S, Cuomo A, Campanale S, Monatti G, Bianco T, Milli V, Antonelli L, Fanin L, Faiola L, Stefanizzi R, Mariani M, Rossi A, Regnani ST, Loreni F, Cianfrocca R, Pisani A, Faraolfi V, Ponzalli P, Savli T, Cresci M, Guardalben S, Belluzzo B, Ruberti R, Zizzi M, Tonda C, Cadrobbi MG, Gilardi R, Mondì A, Costa A, Milan S, Zottarelli A, Parodi B, Sartorio N, Rossin B, Santi A, Cagnan P, Maradei E, Cauteruccio A, Carpino C, Addeo R, Izzo A, Amendola G, Prizzitano AM, Piluso GM, Iadevaio AL, Cinà MT, Cirrincione V, Gumina S, Codato G, Raimondo F, Cappiello MG, Creta F, Barbieri M, Chiarella L, Abbondio L, Piccin M, Spillone V, Cutrupi G, Ruggeri A, Sicilia G, Provengano A, Marcari P, Ricci S, Pazzagli E, La Grotteria M, Orsini R, Leandri L, Vetere NA, Braggion E, Giordanino S, Armando S, Zampieri E, Danese MC, Valentini A, Ferrante MG, Santacroce C, Crocetti I, Macchi F, Bernacchi M, Pini D, Varì M, Lucente M, Scaramastra F, Reichardt S, Gabasio S, Zocchi C, Studhika M, Budzowska E, Cescon M, Lazzari D, Prizzon A, Di Biaggio P, Buda C, Mastrangelo V, Avigliano M, Dell'Aquila L, Bonanomi E, Mezzani A, Porcini F, Girardi G., PERRONE FILARDI, PASQUALE, Rete Infermieri GISSI, Hf, Di Giulio, P, Pera, C, Scarano, M, Ferri, B, Lepore, V, Miani, D, Tognoni, G, Rosson, V, Serafini, C, Zumino, Mt, Partemi, L, Falleroni, Ml, Moretti, L, Porta, L, Santorsola, A, Tenerelli, T, Bertoncelli, B, Mengoli, G, Stagnitto, M, Puddu, Gm, Masini, E, Pasini, A, Boni, S, Valsesia, E, Cornacini, G, Melis, D, Mulina, A, Giurlanda, A, Fava, M, Bellini, P, Vallucci, S, Cuomo, A, Campanale, S, Monatti, G, Bianco, T, Milli, V, Antonelli, L, Fanin, L, Faiola, L, Stefanizzi, R, Mariani, M, Rossi, A, Regnani, St, Loreni, F, Cianfrocca, R, Pisani, A, Faraolfi, V, Ponzalli, P, Savli, T, Cresci, M, Guardalben, S, Belluzzo, B, Ruberti, R, Zizzi, M, Tonda, C, Cadrobbi, Mg, Gilardi, R, Mondì, A, Costa, A, Milan, S, Zottarelli, A, Parodi, B, Sartorio, N, Rossin, B, Santi, A, Cagnan, P, Maradei, E, Cauteruccio, A, Carpino, C, Addeo, R, Izzo, A, Amendola, G, PERRONE FILARDI, Pasquale, Prizzitano, Am, Piluso, Gm, Iadevaio, Al, Cinà, Mt, Cirrincione, V, Gumina, S, Codato, G, Raimondo, F, Cappiello, Mg, Creta, F, Barbieri, M, Chiarella, L, Abbondio, L, Piccin, M, Spillone, V, Cutrupi, G, Ruggeri, A, Sicilia, G, Provengano, A, Marcari, P, Ricci, S, Pazzagli, E, La Grotteria, M, Orsini, R, Leandri, L, Vetere, Na, Braggion, E, Giordanino, S, Armando, S, Zampieri, E, Danese, Mc, Valentini, A, Ferrante, Mg, Santacroce, C, Crocetti, I, Macchi, F, Bernacchi, M, Pini, D, Varì, M, Lucente, M, Scaramastra, F, Reichardt, S, Gabasio, S, Zocchi, C, Studhika, M, Budzowska, E, Cescon, M, Lazzari, D, Prizzon, A, Di Biaggio, P, Buda, C, Mastrangelo, V, Avigliano, M, Dell'Aquila, L, Bonanomi, E, Mezzani, A, Porcini, F, and Girardi, G.

Subjects
Aged, 80 and over, Heart Failure, Male, Time Factors, Depression, Cardiology, Prognosis, Education, Hospitalization, Nursing Research, Sex Factors, Italy, Risk Factors, Prevalence, Quality of Life, Humans, Female, Mortality, Cognition Disorders, Aged, Randomized Controlled Trials as Topic
Abstract

The prevalence of cognitive impairment (CI) is reported to be higher in heart failure patients than in the general population.To describe the prevalence of CI and to assess its prognostic value on the increased risk of hospitalizations and death over the medium term (3 years).MMSE was administered to 620/745 heart failure patients70 years. Up to 35% of the tested population were classified as mild CI and 12% as moderate. The severity of baseline clinical conditions, as expressed as NYHA classes, do not appear to be associated to different degrees of CI. The subgroup of patients with moderate CI includes higher proportion of people with the lowest educational level, of feminine gender, of higher age (80). Even in a population closely monitored as the one included in the GISSI-HLF trial, it is worth to be underlined that the presence of moderate CI appears to be strongly prognostic of an increased burden of care (hospitalizations), and of death over the whole observation period of the study (3 years).The presence of even mild or moderate CI is prognostic for increased mortality and readmissions for patients of the same NYHA class. In the absence of effective intervention strategies, research should concentrate on the yield, if any, of a systematic screening for CI in heart failure patients.

Published
2009

7. [Quality of life, depression and cognitive functions 5. Depression]

Author

Rete Infermieri GISSI HF, Di Giulio P, Pera C, Scarano M, Ferri B, Lepore V, Miani D, Tognoni G, Rosson V, Serafini C, Zumino MT, Partemi L, Falleroni ML, Moretti L, Porta L, Santorsola A, Tenerelli T, Bertoncelli B, Mengoli G, Stagnitto M, Puddu GM, Masini E, Pasini A, Boni S, Valsesia E, Cornacini G, Melis D, Mulina A, Giurlanda A, Fava M, Bellini P, Vallucci S, Cuomo A, Campanale S, Monatti G, Bianco T, Milli V, Antonelli L, Fanin L, Faiola L, Stefanizzi R, Mariani M, Rossi A, Regnani ST, Loreni F, Cianfrocca R, Pisani A, Faraolfi V, Ponzalli P, Savli T, Cresci M, Guardalben S, Belluzzo B, Ruberti R, Zizzi M, Tonda C, Cadrobbi MG, Gilardi R, Mondì A, Costa A, Milan S, Zottarelli A, Parodi B, Sartorio N, Rossin B, Santi A, Cagnan P, Maradei E, Cauteruccio A, Carpino C, Addeo R, Izzo A, Amendola G, Prizzitano AM, Piluso GM, Iadevaio AL, Cinà MT, Cirrincione V, Gumina S, Codato G, Raimondo F, Cappiello MG, Creta F, Barbieri M, Chiarella L, Abbondio L, Piccin M, Spillone V, Cutrupi G, Ruggeri A, Sicilia G, Provengano A, Marcari P, Ricci S, Pazzagli E, La Grotteria M, Orsini R, Leandri L, Vetere NA, Braggion E, Giordanino S, Armando S, Zampieri E, Danese MC, Valentini A, Ferrante MG, Santacroce C, Crocetti I, Macchi F, Bernacchi M, Pini D, Varì M, Lucente M, Scaramastra F, Reichardt S, Gabasio S, Zocchi C, Studhika M, Budzowska E, Cescon M, Lazzari D, Prizzon A, Di Biaggio P, Buda C, Mastrangelo V, Avigliano M, Dell'Aquila L, Bonanomi E, Mezzani A, Porcini F, Girardi G., PERRONE FILARDI, PASQUALE, Rete Infermieri GISSI, Hf, Di Giulio, P, Pera, C, Scarano, M, Ferri, B, Lepore, V, Miani, D, Tognoni, G, Rosson, V, Serafini, C, Zumino, Mt, Partemi, L, Falleroni, Ml, Moretti, L, Porta, L, Santorsola, A, Tenerelli, T, Bertoncelli, B, Mengoli, G, Stagnitto, M, Puddu, Gm, Masini, E, Pasini, A, Boni, S, Valsesia, E, Cornacini, G, Melis, D, Mulina, A, Giurlanda, A, Fava, M, Bellini, P, Vallucci, S, Cuomo, A, Campanale, S, Monatti, G, Bianco, T, Milli, V, Antonelli, L, Fanin, L, Faiola, L, Stefanizzi, R, Mariani, M, Rossi, A, Regnani, St, Loreni, F, Cianfrocca, R, Pisani, A, Faraolfi, V, Ponzalli, P, Savli, T, Cresci, M, Guardalben, S, Belluzzo, B, Ruberti, R, Zizzi, M, Tonda, C, Cadrobbi, Mg, Gilardi, R, Mondì, A, Costa, A, Milan, S, Zottarelli, A, Parodi, B, Sartorio, N, Rossin, B, Santi, A, Cagnan, P, Maradei, E, Cauteruccio, A, Carpino, C, Addeo, R, Izzo, A, Amendola, G, PERRONE FILARDI, Pasquale, Prizzitano, Am, Piluso, Gm, Iadevaio, Al, Cinà, Mt, Cirrincione, V, Gumina, S, Codato, G, Raimondo, F, Cappiello, Mg, Creta, F, Barbieri, M, Chiarella, L, Abbondio, L, Piccin, M, Spillone, V, Cutrupi, G, Ruggeri, A, Sicilia, G, Provengano, A, Marcari, P, Ricci, S, Pazzagli, E, La Grotteria, M, Orsini, R, Leandri, L, Vetere, Na, Braggion, E, Giordanino, S, Armando, S, Zampieri, E, Danese, Mc, Valentini, A, Ferrante, Mg, Santacroce, C, Crocetti, I, Macchi, F, Bernacchi, M, Pini, D, Varì, M, Lucente, M, Scaramastra, F, Reichardt, S, Gabasio, S, Zocchi, C, Studhika, M, Budzowska, E, Cescon, M, Lazzari, D, Prizzon, A, Di Biaggio, P, Buda, C, Mastrangelo, V, Avigliano, M, Dell'Aquila, L, Bonanomi, E, Mezzani, A, Porcini, F, and Girardi, G.

Subjects
Male, Time Factors, Depression, Health Status, Cardiology, Patient Readmission, Hospitalization, Nursing Research, Cognition, Sex Factors, Italy, Risk Factors, Data Interpretation, Statistical, Prevalence, Quality of Life, Humans, Female, Mortality, Geriatric Assessment, Aged, Randomized Controlled Trials as Topic
Abstract

Depression is common in patients with heart failure but its causal and/or prognostic role with respect to the cardiac condition in still a matter of research.To describe the prevalence of depression and to assess its specific prognostic value in terms of increased risk of hospitalizations or death.Overall, 27.5% of 1495 patients experience symptoms of depression. Risk factors for depression are female sex, age70, higher NYHA class, previous hospitalizations and comorbidities. Depressed patients of the same NYHA class are at higher risk for 1 and 3 years mortality and all causes hospital admissions.Depression, assessed with a simple and easy to administer instrument, can add information to clinical variables in the identification of patients at increased risk of mortality and readmissions within the same NYHA class.

Published
2009

8. [Neurovegetative changes before and during episodes of silent ischemia in variant angina]

Author

Bia E, Ga, Lanza, Manzoli A, Stazi F, Colonna G, PATRIZIA PEDROTTI, Lucente M, and Maseri A

Subjects
Adult, Aged, 80 and over, Angina Pectoris, Variant, Male, Electrocardiography, Ambulatory, Myocardial Ischemia, Humans, Female, Middle Aged, Autonomic Nervous System, Aged
Abstract

In order to evaluate whether variations in autonomic nervous tone have a significant role in the induction of coronary arterial spasm in variant angina, we analyzed the changes in heart rate variability (HRV) related to spontaneous episodes of ST-segment elevation, recorded during 24-hour ambulatory ECG monitoring, in 13 patients with variant angina (9 men and 4 women, aged 63 +/- 12 years). In order to obtain an accurate analysis of HRV changes, we only included ischemic episodes characterized by silent ST-segment elevation, lasting at least 3 min and without any ST change in the previous 30 min. HRV indexes in the time domain (RR interval, standard deviation of RR intervals [SD], pNN50, r-MSSD) and in the frequency domain (LF = 0.04-0.15 Hz, HF = 0.15-0.40 HZ, LF/HF ratio) were calculated on 2 min intervals, centered at 15 min before (15B), 5 min before ed 1 min before (1B) the appearance of ST elevation, as well as at peak of ST-segment elevation. Of 161 ischemic episodes found on 24-hour Holter recordings, 60 (37%) fulfilled the inclusion criteria for analysis (4.6 +/- 3.5 episodes/patient, range 1-12). The duration of the selected episodes was 6 +/- 2.5 min and ST elevation was 2.2 +/- 1.0 mm. Heart rate (HR) did not have any change before ST elevation, whereas it showed a small, but significant increase at peak ST (73 +/- 12 versus 67 +/- 11 b/min at 15B, p0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Published
1994

9. Circadian distribution of ischemic attacks and ischemia-related ventricular arrhythmias in patients with variant angina

Author

Ga, Lanza, Giuseppe Patti, Pasceri V, Manolfi M, Sestito A, Lucente M, Crea F, and Maseri A

Subjects
Angina Pectoris, Variant, Myocardial Ischemia, Ventricular Dysfunction, Humans, Arrhythmias, Cardiac, Circadian Rhythm
Abstract

There are limited data about the circadian distribution of ischemic episodes in patients with variant angina. Furthermore, no previous study investigated whether ischemia-related ventricular arrhythmias follow a circadian variation in these patients.The circadian variation of transient ischemia and ischemia-induced ventricular arrhythmias was assessed by cosinor methodology on 24-hour Holter recordings of 26 patients with variant angina.On the whole, 301 ischemic episodes were detected in the population, with premature ventricular complexes occurring in 49 of them (16%). Ischemic episodes followed a typical circadian variation (acrophase hr 02:36, p0.01) in the total sample. However, a significant circadian variation of ischemic episodes was detectable in the 14 patients without (n = 167, acrophase hr 04:00, p0.0001), but not in the 12 patients with (n = 134, p = 0.14) hemodynamically significant coronary stenoses, independently of the location (anterior/inferior) of ischemia. There was no significant circadian variation of ischemia-related ventricular arrhythmias.Among patients with variant angina, a clearcut circadian variation of ischemia is present in those without, but not in those with, hemodynamically significant coronary artery stenoses, thus suggesting that different pathophysiologic mechanisms may operate, at least in part, in triggering coronary spasm in these two subgroups of patients. There was no significant circadian variation of ischemia-related ventricular arrhythmias in these patients.

10. Dilated cardiomyopathy in mucolipidosis type 2

Author

Carboni, E., Sestito, S., Lucente, M., Morrone, A., Zampini, L., Chimenz, R., Ceravolo, M. D., De Sarro, R., Ceravolo, G., Calabro, M. P., Parisi, F., Moricca, M. T., Pensabene, L., Musolino, D., and Concolino, D.

Subjects
dilated cardiomyopathy, Cardiomyopathy, Dilated, GNPTAB gene, Mucolipidoses, Mutation, mucolipidosis, Humans, Infant, Transferases (Other Substituted Phosphate Groups), Female, GNPTG gene, Child, dilated cardiomyopathy, GNPTAB gene, GNPTG gene, mucolipidosis
Abstract

Mucolipidosis II and III are lysosomal storage diseases caused by pathogenetic mutations in GNPTAB and GNPTG genes which cause an impaired activity of the lysosomal hydrolase N-acetylglucosamine- 1-phosphotransferase, a key enzyme in the synthesis of the mannose-6-phosphate targeting signals on lysosomal enzymes. Patients with MLII alpha/beta present coarse facial features, cessation of statural growth, important skeletal manifestations, impaired neuromotor development and cardiorespiratory involvement. All children appear to have cardiac involvement, but severe dilated cardiomyopathy is uncommon. In this report we describe the case of an 11-month-old girl who is affected by a MLII. Analysis of the GNPTAB gene identified at a heterozygous level the previously described gene variants c. 2693delA p(Lys898Serfs*13) and c. 2956CT p(Arg986Cys). Her main clinical features were coarse face with gingival hypertrophy, dysostosis multiplex, recurrent respiratory infection and an early onset of dilated cardiomyopathy, an uncommon feature for MLII. To our knowledge, dilated cardiomyopathy has been previously described in literature in only two cases of MLII and in one patient affected by MLIII.

11. Allostatic Load and Its Impact on Health: A Systematic Review

Author

Nicoletta Sonino, Giovanni A. Fava, Jenny Guidi, Marcella Lucente, Guidi J., Lucente M., Sonino N., and Fava G.A.

Subjects
Adult, Gerontology, Population, PsycINFO, Cochrane Library, Stress, Clinimetric, 03 medical and health sciences, 0302 clinical medicine, Allostatic overload, Adaptation, Psychological, Lifestyle medicine, Humans, Medicine, 030212 general & internal medicine, Social determinants of health, education, Life Style, Applied Psychology, education.field_of_study, business.industry, Biomarker, General Medicine, Mental health, Allostatic load, 030227 psychiatry, Psychiatry and Mental health, Clinical Psychology, Diagnostic Criteria for Psychosomatic Research, Allostasis, business, Psychosocial, Biomarkers, Stress, Psychological
Abstract

Introduction: Allostatic load refers to the cumulative burden of chronic stress and life events. It involves the interaction of different physiological systems at varying degrees of activity. When environmental challenges exceed the individual ability to cope, then allostatic overload ensues. Allostatic load is identified by the use of biomarkers and clinical criteria. Objective: To summarize the current knowledge on allostatic load and overload and its clinical implications based on a systematic review of the literature. Methods: PubMed, PsycINFO, Web of Science, and the Cochrane Library were searched from inception to December 2019. A manual search of the literature was also performed, and reference lists of the retrieved articles were examined.We considered only studies in which allostatic load or overload were adequately described and assessed in either clinical or non-clinical adult populations. Results: A total of 267 original investigations were included. They encompassed general population studies, as well as clinical studies on consequences of allostatic load/overload on both physical and mental health across a variety of settings. Conclusions: The findings indicate that allostatic load and overload are associated with poorer health outcomes. Assessment of allostatic load provides support to the understanding of psychosocial determinants of health and lifestyle medicine. An integrated approach that includes both biological markers and clinimetric criteria is recommended.

Published
2020
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12. Allostatic overload in patients with essential hypertension

Author

Marcella Lucente, Jenny Guidi, Nicoletta Sonino, Chiara Rafanelli, Antonio Piolanti, Renzo Roncuzzi, Guidi J., Lucente M., Piolanti A., Roncuzzi R., Rafanelli C., and Sonino N.

Subjects
Adult, Male, Diagnostic Criteria for Psychosomatic Research (DCPR), medicine.medical_specialty, Endocrinology, Diabetes and Metabolism, Stress, Essential hypertension, Clinimetric, 03 medical and health sciences, 0302 clinical medicine, Endocrinology, Allostatic overload, Surveys and Questionnaires, Internal medicine, Outpatients, medicine, Humans, In patient, Biological Psychiatry, Aged, Psychiatric Status Rating Scales, Endocrine and Autonomic Systems, business.industry, Psychological distre, Mental Disorders, Psychological distress, Mean age, Middle Aged, medicine.disease, Research findings, Psychophysiologic Disorders, 030227 psychiatry, Psychosocial Functioning, Psychiatry and Mental health, Allostasis, Hypertension, Psychosocial stress, Quality of Life, Female, Essential Hypertension, business, Stress, Psychological, 030217 neurology & neurosurgery
Abstract

The role of psychosocial stress in the development of essential hypertension has attracted increasing attention in the last decades, even though research findings have been often inconclusive. We specifically investigated allostatic overload (AO) in hypertensive patients using a clinimetric approach. Allostatic overload was assessed by a semi-structured research interview based on clinimetric criteria in 80 consecutive outpatients with essential hypertension (46.3 % females; mean age 62.18 ± 8.59 years; age range 47–74 years) and 80 normotensive matched controls. Three clinical interviews and two self-rating questionnaires for assessing psychological distress and well-being were also administered. Cardiac variables were collected. AO was present in 26 (32.5 %) of the hypertensive patients based on clinical interviewing, and in only 6 normotensive controls (p < .001). Hypertensive patients with AO had significantly higher levels of psychological distress than those without. Further, patients with AO displayed significantly lower levels of well-being and quality of life (p < .001). A significantly greater prevalence of psychosomatic syndromes was found to be associated with the presence of AO (p < .05), whereas no significant association was detected as to psychiatric diagnoses. Significantly greater cardiovascular risk was found among hypertensive patients reporting AO compared to those without (p < .05). The results of this study support the clinical relevance of a psychological assessment of hypertensive patients, with important implications for the non-pharmacological management of hypertension.

Published
2020
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