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psyc 314 psychosocial interventions for chronic illness.doc

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PSYC 314
Frances Chen

psyc 314 Psychosocial interventions for chronic illnesses treating depression in coronary patients: • Davidson,Archives of Internal Medicine, 2010 • Patients with acute coronary syndrome & depression • Intervention: problem-solving therapy and/or meds vs usual care • Outcome: experience of adverse cardiac event over 9-month follow up period davidson 2010 they took people who have heart symptoms due to coronary disease (patients who have cardiovascular disease) and who are depressed they took people who were diagnosed with depression for 3 months or longer (they did this because they wanted to have people with chronic depression--not just acute depression due to the onset of the cardiovascular disease) intervention: problem focused therapy developing problem solving skills and having patients engage in pleasurable activities with the option to take medication with depression compared to usual care (whatever their physician told them to do--could include antidepressants) the intervention is focused specifically around the depression, not the heart disease outcome: every week for 30-40 minutes to teach problem solving skills to the people in the intervention group and then they looked to see who experienced adverse cardiac events over a 9 month follow-up period Results: giving this treatment for depression significantly lowers their chance of experiencing a cardiac event in the future. The usual care group has the most coronary events. The intervention group has the same amount of cardiac events as a group of people who were never depressed. stress interventions- Disclosure a simple intervention: it is writing based where you write about stressful events which you have experiences--linking it to personal issues and growth. Disclosure intervention: • Smyth et al., Journal of theAmerican MedicalAssociation, 1999 • Patients with asthma or rheumatoid arthritis • Emotional writing or neutral writing -3 consecutive days, 20 minutes each • Outcomes: 4 months later -Asthma, pulmonary function (FEV1) -Arthritis, MD rating of clinical status Smyth 1999. recruited people with asthma or rhumatoid arthritis and had them engage in emotional writing for 3 days in a row for 20 minutes a day about the most stressful thing that happened in their life OR they had to write about neutral subjects such as their plans for the day (the comparison group) outcomes: over the next four months they looked to see how asthma was doing (take the deepest breath they can and then quickly exhale to see how abstructed their air ways are) and look at a clinical status for those with arthritis (people who made this statement were blind to the condition of the patient) results: they found that patients in the experimental group who have asthma have significantly better pulminary function compared to themselves at baseline and compared to the control group (they are stronger and faster at blowing air out meaning their air way is not as blocked). The same pattern was seen with arthritis. At baseline both groups are the same, at 4 month follow-up the control group is the same as baseline and the experimental group showed less symptom severity than the control group and themselves at baseline (they have less disease severity) they think that getting out thoughts and feeling (whether you say them to someone else or not) is sufficient to get a result researchers think that writing about a stressful event woul
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