scholarly journals Motivation to Quit Smoking after Acute Coronary Syndrome

2017 ◽  
Vol 30 (1) ◽  
pp. 34 ◽  
Author(s):  
Vânia Rocha ◽  
Marina Guerra ◽  
Marina Lemos ◽  
Júlia Maciel ◽  
Geoffrey Williams
Keyword(s):  
Acute Coronary Syndrome ◽  
Meaning In Life ◽  
Smoking Status ◽  
Self Regulation ◽  
Self Determination Theory ◽  
Perceived Competence ◽  
Theory Model ◽  
Self Determination ◽  
Coronary Syndrome ◽  
Quit Smoking

Introduction: Self-Determination Theory explores the process through which a person acquires motivation to initiate new behaviours related to health and to maintain them over time. This study aimed to determine the overall fit of Self-Determination Theory Model for Health Behavior to the data obtained from a sample of smokers hospitalized with acute coronary syndrome, and to identify the predictors of smoking status six months after clinical discharge.Material and Methods: The sample included 110 participants, regular smokers, hospitalized due to acute coronary syndrome. Questionnaires were administered to assess autonomous self-regulation, perceived competence, family support, depressive symptoms and meaning in life. Participants were asked if they were currently smokers six months after clinical discharge.Results: The results showed that the process variables specified by Self-Determination Theory fit the data well. Perceived competence predicted abstinence from smoking six months after clinical discharge.Discussion: Our findings have similar characteristics to other international samples in which Self-Determination Theory models havebeen tested. It is important to facilitate perceived competence, as the patients who continue to smoke have shorter length of life.Conclusion: This study highlights the importance of considering clinical interventions based on Self-Determination Theory to facilitatesmoking cessation.

scholarly journals Impact of smoking cessation on depression after acute coronary syndrome

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
K Krasieva ◽  
C Clair ◽  
B Gencer ◽  
D Carballo ◽  
R Klingenberg ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Acute Coronary Syndrome ◽  
Smoking Status ◽  
Antidepressant Drug ◽  
Depression Scale ◽  
Lifestyle Changes ◽  
Cardiac Events ◽  
Coronary Syndrome ◽  
Quit Smoking ◽  
One Year

Abstract Background Smoking and depression are two risk factors for acute coronary syndrome (ACS) that often go hand-in-hand, as smokers are more likely to be depressed and people that are depressed are more likely to be smokers. Smoking cessation in depressed patients with ACS may worsen depressive symptoms, which could increase the risk of recurrence of cardiac events and decrease adherence to other cardiac risk-reducing lifestyle changes. Purpose We aimed to investigate the evolution of depression according to smoking cessation one-year after ACS. Furthermore, we investigated if there was a higher incidence of one-year depression among ACS smokers who quit in comparison to continuous smokers. Method Data from 1,822 patients with ACS of the Swiss multicenter SPUM-ACS cohort study were analysed over a one-year follow-up period. Participants were classified in three groups based on smoking status one-year post-ACS – continuous smokers, smokers who quit within the year post-ACS, and non-smokers. Depression status at baseline and at one-year after the index ACS event was assessed with the Center for Epidemiologic Studies Depression scale (CES-D) and antidepressant drug use. A multivariate adjusted logistic regression model was used to calculate the risk ratio (RR) between groups. Results In comparison to depressed smokers who continued to smoke one year post-ACS, depressed smokers who quit smoking had an adjusted RR of 2.02 (95% CI 1.04–3.92) of improving their depression. Among 543 non-depressed ACS smokers, new depression at one-year was found in 57/266 (21.4%) smokers who quit, and 68/277 (24.6%) continuous smokers, with an adjusted RR of 0.89 (95% CI 0.58–1.36) of incidence of new depression. Conclusion Smokers with depression at the time of ACS who quit smoking improved more frequently their depression compared to those who continued smoking. Although not statistically significant, there was a smaller incidence of new depression among smokers who quit after ACS in comparison to continuous smokers. FUNDunding Acknowledgement Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Swiss National Science Foundation

Smoking Abstinence Twelve Months after an Acute Coronary Syndrome

2017 ◽  
Vol 20 ◽  
Author(s):  
Vânia Rocha ◽  
Marina P. Guerra ◽  
Marina S. Lemos ◽  
Júlia Maciel ◽  
Geoffrey C. Williams
Keyword(s):  
Social Support ◽  
Smoking Cessation ◽  
Acute Coronary Syndrome ◽  
Depressive Symptoms ◽  
Nicotine Dependence ◽  
Meaning In Life ◽  
Perceived Competence ◽  
Coronary Syndrome ◽  
Over Time

AbstractStudies on the cognitive working mechanism of smoking cessation in high-risk populations are few and much needed, and identifying long-term psychosocial factors to smoking cessation are relevant to improve intervention for cardiac patient groups. This longitudinal study followed patients who smoked and suffered an acute coronary syndrome from hospitalization to 12 months after clinical discharge. Questionnaires were administered to assess nicotine dependence, behavioral dependence, autonomous self-regulation, perceived competence, social support, anxiety, depressive symptoms and meaning in life at baseline, six months and twelve months after clinical discharge. The results showed that anxiety (F(2, 62) = 28.10, p < .001, ηp2 = .48) and depressive symptoms (F(2, 62) = 10.42, p < .001, ηp2 = .25) decreased over time, whereas meaning in life (F(2, 61) = 44.77, p < .001, ηp2 = .59) and social support increased (t(63) = –4.54, p < .001, 95% IC[–11.05, 4.29], η2 =.25). Smoking dependence was negatively predicted by change in perceived competence (B = –2.25, p = .011, 95% IC[.02, .60]) and positively by change in depressive symptoms (B =.37, p = .042, 95% IC[1.01, 2.05]) 12 months after clinical discharge. Nicotine dependence (t(17) = 2.76, p = .014, 95% IC[.39, 2.94], η2 =.31) and the number of cigarettes smoked per day (t(17) = 4.48, p < .001, 95% IC[5.49, 15.29], η2 =.54) decreased over time, whereas behavioral dependence increased among smokers (t(17) = –2.37, p = .030, 95% IC[–4.30, 2.54], η2 =.25). This study suggests that long term abstinence in cardiac patients may be enhanced by psychological interventions addressing perceived competence, depressive symptoms and behavioral dependence.

Self-determination theory and motivation for music

2017 ◽  
Vol 46 (5) ◽  
pp. 699-715 ◽  
Author(s):  
Peter D. MacIntyre ◽  
Ben Schnare ◽  
Jessica Ross
Keyword(s):  
Online Survey ◽  
Self Determination Theory ◽  
Perceived Competence ◽  
Self Determination ◽  
Music Learning ◽  
Motivational Constructs ◽  
Motivational Intensity ◽  
Proposed Model ◽  
And Performance ◽  
Virtuous Cycle

Learning the skills to be a musician requires an enormous amount of effort and dedication, a long-term process that requires sustained motivation. Motivation for music is complex, blending relatively intrinsic and extrinsic motives. The purpose of this study is to investigate the motivation of musicians by considering how different aspects of motivational features interact. An international sample of 188 musicians was obtained through the use of an online survey. Four scales drawn from Self-Determination Theory (intrinsic, identified, introjected, and extrinsic regulation) were utilized along with other motivational constructs, including motivational intensity, desire to learn, willingness to play, perceived competence, and musical self-esteem. To integrate the variables into a proposed model, a path analysis was conducted among the motivation variables. Results showed that the intrinsic motives are playing the major role in the maintenance of the motivational system, while extrinsic motives are less influential. Support was found for a feedback loop, whereby desire to learn feeds into increased effort at learning (i.e., motivational intensity), leading to the development of perceived competence, which is then reflected back into increasing desire to learn. Increases in these variables help to create a virtuous cycle of motivation for music learning and performance.

scholarly journals Interactive Participatory Audit and Feedback (IPAF): Theory-based development and multi-site implementation outcomes with specialty clinic staff

2020 ◽  
Author(s):  
Edmond Ramly ◽  
Diane Lauver ◽  
Andrea Gilmore-Bykovskyi ◽  
Christie M Bartels
Keyword(s):  
Risk Reduction ◽  
Self Regulation ◽  
Self Determination Theory ◽  
Self Determination ◽  
Audit And Feedback ◽  
Evidence Based ◽  
Cvd Risk ◽  
Frontline Staff ◽  
Target Behaviors ◽  
Implementation Outcomes

Abstract Background: Theory-based implementation strategies, such as audit and feedback (A&F), can improve adoption of evidence-based practices. However, few strategies have been developed and tested to meet the needs of specialty clinics. In particular, frontline staff can execute CVD risk-reduction protocols, but A&F strategies to support them have not been well examined. Our objective was to develop and evaluate a novel A&F strategy, Interactive Participatory A&F (IPAF). Methods: We developed IPAF by combining theories to inform staff goals (Self-Regulation Theory) and address their psychological needs for relatedness, autonomy, and confidence (Self-Determination Theory). We facilitated IPAF fidelity by developing a theory-based facilitation tool: a semi-structured worksheet to guide flexible discussion of target behaviors, perceived barriers, goals, and action plans. We evaluated IPAF in the context of eight quasi-experimental implementations in specialty clinics across two health systems. Following a Hybrid Type 2 effectiveness-implementation design, we reported intervention outcomes for CVD risk-reduction elsewhere. This paper reports implementation outcomes associated with IPAF, focusing on feasibility, acceptability, fidelity, and adoption. We evaluated implementation outcomes using mixed-methods data including Electronic Health Records (EHR) data, team records, IPAF worksheets, and staff questionnaire responses. Results: Eighteen staff participated in 99 monthly, individual, synchronous (face-to-face or by phone) IPAF sessions during the first six months of implementation. Subsequently, we provided over 375 monthly feedback emails. Feasibility data revealed high staff attendance (90-93%) and engagement in IPAF sessions. Staff rated questionnaire items about acceptability of IPAF highly. IPAF records and staff responses demonstrated fidelity of delivery and receipt of IPAF. Adoption of target behaviors increased significantly (all P-values < 0.05) and was maintained for over 24 months. Conclusions: We developed and evaluated an interactive participatory A&F strategy with frontline staff in specialty clinics to improve implementation of evidence-based interventions. The IPAF toolkit combines two complementary theories: Self-Regulation Theory and Self-Determination Theory. Findings support feasibility, acceptability, and fidelity of IPAF, and staff adoption and maintenance of target behaviors. By evaluating multi-site implementation outcomes, we have extended prior research on clinic protocols and A&F beyond primary care settings and providers.

scholarly journals Adverse Outcome Prediction of Iron Deficiency in Patients with Acute Coronary Syndrome

Biomolecules ◽  
2018 ◽  
Vol 8 (3) ◽  
pp. 60 ◽  
Author(s):  
Tanja Zeller ◽  
Christoph Waldeyer ◽  
Francisco Ojeda ◽  
Renate Schnabel ◽  
Sarina Schäfer ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Acute Coronary Syndrome ◽  
Iron Deficiency ◽  
Cardiovascular Mortality ◽  
Adverse Outcome ◽  
Smoking Status ◽  
Coronary Syndrome ◽  
Iron Deficient ◽  
Increased Risk

Acute myocardial infarction remains a leading cause of morbidity and mortality. While iron deficient heart failure patients are at increased risk of future cardiovascular events and see improvement with intravenous supplementation, the clinical relevance of iron deficiency in acute coronary syndrome remains unclear. We aimed to evaluate the prognostic value of iron deficiency in the acute coronary syndrome (ACS). Levels of ferritin, iron, and transferrin were measured at baseline in 836 patients with ACS. A total of 29.1% was categorized as iron deficient. The prevalence of iron deficiency was clearly higher in women (42.8%), and in patients with anemia (42.5%). During a median follow-up of 4.0 years, 111 subjects (13.3%) experienced non-fatal myocardial infarction (MI) and cardiovascular mortality as combined endpoint. Iron deficiency strongly predicted non-fatal MI and cardiovascular mortality with a hazard ratio (HR) of 1.52 (95% confidence interval (CI) 1.03-2.26; p = 0.037) adjusted for age, sex, hypertension, smoking status, diabetes, hyperlipidemia, body-mass-index (BMI) This association remained significant (HR 1.73 (95% CI 1.07–2.81; p = 0.026)) after an additional adjustment for surrogates of cardiac function and heart failure severity (N-terminal pro B-type natriuretic peptide, NT-proBNP), for the size of myocardial necrosis (troponin), and for anemia (hemoglobin). Survival analyses for cardiovascular mortality and MI provided further evidence for the prognostic relevance of iron deficiency (HR 1.50 (95% CI 1.02–2.20)). Our data showed that iron deficiency is strongly associated with adverse outcome in acute coronary syndrome.

Parenting, self-regulation, and treatment adherence in pediatric chronic headache: A self-determination theory perspective

2019 ◽  
pp. 135910531988459 ◽  
Author(s):  
Alessandra Caruso ◽  
Wendy Grolnick ◽  
Jonathan Rabner ◽  
Alyssa Lebel
Keyword(s):  
Treatment Adherence ◽  
Autonomy Support ◽  
Chronic Headache ◽  
Self Regulation ◽  
Self Determination Theory ◽  
Self Determination ◽  
Lower Treatment ◽  
Headache Clinic ◽  
Maternal Autonomy

This study examined parenting factors associated with children’s self-regulation and physician-rated treatment adherence using a self-determination theory framework in pediatric chronic headache. Participants were 58 children and adolescents (aged 10–17 years), who underwent initial and follow-up multidisciplinary evaluation at a headache clinic, and their mothers. Regression analyses showed that higher maternal autonomy support and structure were significantly related to children’s lower treatment-related reactance and higher adherence. Maternal controllingness had associations in the opposite directions. Children’s fear of pain was related to maternal controllingness. Results suggest the importance of parents’ provision of clear expectations and engaging children in treatment problem-solving and decision-making.

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