Psychosocial Factors and Hospital Readmission Status of Older Persons with Cardiovascular Disease

Abstract

One hundred twenty-one (121) patients 55 years and older, having cardiovascular disease, were followed for 90 days to identify factors that might be used as predictors for hospital readmission. An initial step was to determine which health status or psychosocial measures would best discriminate between two readmission groups (readmission vs. no readmission). Four factors were univariately significant: physical health, personal adjustment, happiness, and number of secondary disorders. At the end of the specified follow-up period, 71 persons (58.7%) had experienced at least one unplanned readmission. Specifically, persons reporting a positive affect about their present circumstances, and enhanced optimism about their future, were less likely to be readmitted. Further, patients who were readmitted reported worse physical health before their readmission and had a greater number of secondary disorders. It is recommended that these factors be used in a multiple discriminant predictive model in future studies to detect their potential for predicting hospital readmission. If identification of at risk characteristics for repeated admissions among predictable high cost groups can be achieved, these data can supply rehabilitation professionals with the necessary information needed for the design of comprehensive and intensive cost-effective interventions in cardiac rehabilitation. Clinical applications for the rehabilitation counselor are discussed with respect to intervention considerations and the community reintegration of the older person from the hospital to their home and other independent living settings.

Relationships between positive psychological constructs and health outcomes in patients with cardiovascular disease: A systematic review

“…However, in the Middleton et al [37] study of 121 patients hospitalized for cardiovascular disease, there was no relationship between baseline optimism/hope and 90-day all-cause readmissions.…”

“…In one study (Hoogwegt [35]), the SD of the psychological construct (Global Mood Scale; GMS [36]) was not provided, but population norm data for the measure was available in the same (cardiac) population [36], and this value was used instead. For an additional study (Middleton [37]), between-group differences in happiness scores were compared by readmission status using t tests; these were converted to an OR for readmissions associated with baseline happiness scores.…”

Social determinants of health: The role of neighbourhoods, psychological factors and health behaviours in predicting health outcomes for the urban poor in India

“…Trait PES has been associated with lower rates of stroke among non institutionalized elderly (Ostir et al, 2001), lower rates of re-hospitalization after coronary disease (Middleton and Byrd, 1996) and less pain among rheumatoid arthritic patients (Potter et al, 2000, as cited in Cohen et al, 2006.…”

Reduced positive affect (anhedonia) is independently associated with 7-year mortality in patients treated with percutaneous coronary intervention: results from the RESEARCH registry

“…4,5 Positive affect refers to mood states such as joy, activity, and cheerfulness, 6 and is not merely the opposite of negative affect, 7 as both types of affect can be present simultaneously. 8 High levels of positive affect have been associated with a decrease in hospital readmissions in patients with CAD, 9 lower incident hypertension, 10 a dampened physiological stress response, 11 and lower incident CAD, 12 whereas studies on the association between positive affect and survival showed mixed results. 5,13 Anhedonia (i.e., reduced positive affect) has been shown to independently predict all-cause mortality and major adverse clinical events (i.e., myocardial infarction, hospitalization, or coronary revascularization) 1 year after an acute cardiac event.…”