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Smoking Cessation After Acute Myocardial Infarction in Relation to Depression and Personality Factors
Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV). Department of Cardiology, Skåne University Hospital, Lund University, Lund and Malmö, Sweden.
Cardiovascular Epidemiology Research Group, Department of Clinical Sciences, Lund University, Malmö, Sweden; Department of Cardiology, Skåne University Hospital, Lund University, Lund and Malmö, Sweden.
Cardiovascular Epidemiology Research Group, Department of Clinical Sciences, Lund University, Malmö, Sweden.
Department of Neurology, Skåne University Hospital, Malmö and Lund, Sweden.
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2016 (English)In: International Journal of Behavioral Medicine, ISSN 1070-5503, E-ISSN 1532-7558, Vol. 23, no 2, p. 234-242Article in journal (Refereed) Published
Abstract [en]

Smoking is an important cardiovascular risk factor and smoking cessation should be a primary target in secondary prevention after a myocardial infarction (MI). The purpose of this study was to examine whether personality, coping and depression were related to smoking cessation after an MI MI patients a parts per thousand currency sign 70 years (n = 323, 73 % men, 58.7 +/- 8.3 years), participating in the Secondary Prevention and Compliance following Acute Myocardial Infarction study in Malmö, Sweden, between 2002 and 2005, were interviewed by a psychologist to assess coping strategies and completed Beck Depression and NEO Personality Inventories, in close proximity to the acute event. Correlation between smoking status (current, former and never), personality factors, coping and depression was assessed at baseline and 24 months after the MI using logistic regression and in a multivariate analysis, adjusting for age and sex Of the participating patients, 46 % were current smokers. Two years after the event, 44 % of these were still smoking. At baseline, current smokers scored higher on the depression and neuroticism scales and had lower agreeableness scores. Patients who continued to smoke after 2 years had higher scores on being confrontational (i.e. confrontative coping style) compared to those who had managed to quit. Patients who continued to smoke had significantly lower agreeableness and were more often living alone Personality, coping strategies and psychosocial circumstances are associated with smoking cessation rates in patients with MI. Considering personality factors and coping strategies to better individualise smoking cessation programs in MI patients might be of importance.

Place, publisher, year, edition, pages
Springer, 2016. Vol. 23, no 2, p. 234-242
Keywords [en]
Personality factor, Depression, Smoking cessation, Acute myocardial infarction, Prevention
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:mau:diva-5645DOI: 10.1007/s12529-015-9514-yISI: 000372256300013PubMedID: 26475034Scopus ID: 2-s2.0-84960260518Local ID: 23051OAI: oai:DiVA.org:mau-5645DiVA, id: diva2:1402509
Available from: 2020-02-28 Created: 2020-02-28 Last updated: 2024-06-17Bibliographically approved
In thesis
1. Myocardial infarction personality factors, coping strategies, depression and secondary prevention
Open this publication in new window or tab >>Myocardial infarction personality factors, coping strategies, depression and secondary prevention
2016 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

A longitudinal study with 400 patients diagnosed with myocardial infarction (MI) was conducted at the Cardiology department at Malmö University hospital in Sweden, between 2002 and 2005. The aim of the project was to identify personality and psychosocial factors, influencing patients’ actions and the prognoses after MI. The five factor model of personality, (measures on Neuroticism, Extraversion, Openness, Agreeableness, and Conscientiousness), coping strategies, depressive symptoms, the impact on delay seeking emergency care, smoking habits and cardiac health care utilization were studied. This thesis reports the result from four papers. In paper I the aim was to investigate whether maladaptive behaviour in the serial Color Word Test (CWT) alone or in combination with any specific personality dimensions were associated with severity of the MI. The indicators of severity of disease were maximum levels above median of the cardiac biomarkers troponin I and creatine-kinase-MB (CKMB), Q-wave infarctions, and a left ventricular ejection fraction (LVEF). The findings showed that maladaptive behaviour in combination with low scores on extraversion was associated with higher levels in cardiac biomarkers, following an MI. Another crucial factor for the prognoses and survival after a MI is early arrival to the emergency department and rapid intervention. In paper II we analysed the correlation of personality and psychosocial factors, with the time lag between the onset of coronary symptoms and seeking emergency hospital care. There was no significant conjunction in time delay and personality factors, coping strategies and depression. In paper III we examined whether personality traits, coping strategies and symptoms of depression were related to smoking cessation after an MI. Out of the 149 patients who smoked at baseline, 2 years follow-up data was available on 133 individuals, of these 44% (n=59) still smoked and 56% (n=74) had stopped smoking during the 2 years. Those who still smoked had lower score in the personality factor agreeableness, more lived alone and were unemployed in contrast to those who had stopped smoking. They also had significantly higher coping scores as confrontational behaviour. Finally, in paper IV we examined whether personality factors and depressive symptoms predicted cardiac health care utilization over the first two years after the MI event. Those MI patients showing traits of Neuroticism at baseline had significantly higher utilization at the out-patient cardiac clinic than those without. Individuals with a high score of depressive symptoms at baseline had instead a higher utilization of social workers and telephone contacts over the two year follow-up. In conclusion, we found that the personality factors extraversion, agreeableness and neuroticism were factors that had impact on MI severity, smoking cessation and out-patient clinic contacts, while delay in seeking acute care was not affected by personality factors, depression or coping strategies. Maladaptive behaviour and a confronting coping strategy influenced MI severity and smoking cessation 2 years after an MI. Taking personality factors and coping strategies more into consideration when caring for patients in cardiac rehabilitation might be indicated.

Place, publisher, year, edition, pages
Malmö University. Faculty of Health and Society, 2016. p. 83
Series
Malmö University Health and Society Dissertations, ISSN 1653-5383 ; 1
Keywords
Acute myocardial infarction, Personality factors, Coping strategies, depression, smoking cessation, Secondary prevention
National Category
Humanities and the Arts
Identifiers
urn:nbn:se:mau:diva-7309 (URN)20214 (Local ID)9789171046666 (ISBN)9789171046673 (ISBN)20214 (Archive number)20214 (OAI)
Note

Paper IV in dissertation as manuscript with title "Personality factors and depression as predictors of health care consumption during the first two years following a myocardial infarction"

Available from: 2020-02-28 Created: 2020-02-28 Last updated: 2024-03-16Bibliographically approved

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