Using a patient-generated mental-health measure ‘PSYCHLOPS’ to explore problems in patients with coronary heart disease

Lawton, Rebecca, Seed, Paul T, Kordowicz, Maria , Schofield, Peter, Tylee, André and Ashworth, Mark (2014) Using a patient-generated mental-health measure ‘PSYCHLOPS’ to explore problems in patients with coronary heart disease. British Journal of General Practice, 64 (623). e354-e363. ISSN 0960-1643

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Background Patients with coronary heart disease (CHD) who are depressed have an increased risk of further cardiac events and higher mortality.
Aim To use a patient generated instrument (PSYCHLOPS) to define categories of concerns in patients with CHD. To define the psychometric characteristics of patients in each category.
Design and setting Cross-sectional study set in general practices in south London.
Method Of 3325 patients on the CHD registers in 15 general practices, 655 completed six baseline psychometric and functional instruments: PSYCHLOPS, HADS-Depression, HADS-Anxiety, Clinical Interview Schedule – Revised, SF12-Mental and SF12-Physical. Content analysis was used to categorise patients based on their main problem, as elicited by PSYCHLOPS. Mean psychometric scores were adjusted for confounding by age, sex, deprivation and ethnicity and calculated for each response category.
Results Response categories were: physical problems, both non-cardiac (23.2%) and cardiac (6.0%); social problems: relationship/family (18.2%), money (7.5%), work (3.1%); functional (9.8%); psychological (6.9%); miscellaneous (7.3%); ‘no problem’ (18.2%). The highest psychological distress scores were found in ‘physical, cardiac’ and ‘psychological’ categories. The ‘no problem’ category had significantly lower psychological distress and higher functional capacity than other categories.
Conclusions PSYCHLOPS enabled the identification of subtypes of CHD patients, based on a classification of self-reported problems. A high proportion of CHD patients report social problems. Psychological distress was highest in those reporting cardiac or psychological symptoms. Services should be aligned to the reported needs of patients.

Keywords:PSYCHLOPS, Coronary heart disease, general practice
Subjects:A Medicine and Dentistry > A990 Medicine and Dentistry not elsewhere classified
Divisions:Lincoln International Business School
ID Code:41592
Deposited On:22 Jul 2020 09:24

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