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Heart, Lung and Circulation

Cultural Differences in Psychological Distress and Illness Perceptions Amongst People Living With Cardiac Inherited Diseases

Published:August 04, 2022DOI:https://doi.org/10.1016/j.hlc.2022.05.046
      Cardiac Inherited diseases (CID) and minority ethnic status are both associated with anxiety and depression. This study aimed to investigate differences in patient experiences of CID between ethnic groups in New Zealand (NZ) in order to inform psychosocial interventions and promote health equity. A cross-sectional survey was administered to a NZ CID database. One-hundred and fifty-two (152) NZ Europeans, 19 Māori, and two Pasifika participated. Māori and Pasifika peoples reported significantly greater symptom perceptions, shorter timeline perceptions, higher perceived risk of severe symptoms, and were less likely to attribute the cause of their CID to hereditary factors than NZ Europeans. Māori and Pasifika also reported more anxiety and distress, although both groups reported beneficial medication perceptions and high medication adherence. Differences could not be attributed to clinical or other demographic variables. The use of screening tools and development of culturally appropriate interventions may help reduce both distress and health inequities.

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      References

        • Wilde A.A.
        • Behr E.R.
        Genetic testing for inherited cardiac disease.
        Nat Rev Cardiol. 2013; 10: 571-583
        • Deo R.
        • Albert C.M.
        Epidemiology and genetics of sudden cardiac death.
        Circulation. 2012; 125: 620-637
        • Schwartz P.J.
        • Stramba-Badiale M.
        • Crotti L.
        • Pedrazzini M.
        • Besana A.
        • Bosi G.
        • et al.
        Prevalence of the congenital long-QT syndrome.
        Circulation. 2009; 120: 1761-1767
        • Hamang A.
        • Eide G.E.
        • Rokne B.
        • Nordin K.
        • Øyen N.
        General anxiety, depression, and physical health in relation to symptoms of heart-focused anxiety-a cross sectional study among patients living with the risk of serious arrhythmias and sudden cardiac death.
        Health Qual Life Outcomes. 2011; 9: 1-10
        • Ingles J.
        • Lind J.M.
        • Phongsavan P.
        • Semsarian C.
        Psychosocial impact of specialized cardiac genetic clinics for hypertrophic cardiomyopathy.
        Genet Med. 2008; 10: 117-120
        • Rasoul D.
        • Potluri S.
        • Wong S.C.
        • Gorantla R.S.
        • Aziz A.
        • Chandran S.
        • et al.
        Psychiatric co-morbidities in patients with dilated cardiomyopathy.
        Int J Cardiol. 2015; 191: 71-73
        • Petrie K.
        • Weinman J.
        Why illness perceptions matter.
        Clin Med. 2006; 6: 536
        • Diefenbach M.A.
        • Leventhal H.
        The common-sense model of illness representation: Theoretical and practical considerations.
        J Soc Distress Homel. 1996; 5: 11-38
        • Christiaans I.
        • Van Langen I.M.
        • Birnie E.
        • Bonsel G.J.
        • Wilde A.A.
        • Smets E.M.
        Quality of life and psychological distress in hypertrophic cardiomyopathy mutation carriers: a cross-sectional cohort study.
        Am J Med Genet. 2009; 149: 602-612
        • Hickey K.T.
        • Sciacca R.R.
        • Biviano A.B.
        • Whang W.
        • Dizon J.M.
        • Garan H.
        • et al.
        The effect of cardiac genetic testing on psychological well-being and illness perceptions.
        Heart Lung. 2014; 43: 127-132
        • Broadbent E.
        • Petrie K.J.
        • Ellis C.J.
        • Ying J.
        • Gamble G.
        A picture of health—myocardial infarction patients' drawings of their hearts and subsequent disability: a longitudinal study.
        J Psychosom Res. 2004; 57: 583-587
        • O’Donovan C.E.
        • Painter L.
        • Lowe B.
        • Robinson H.
        • Broadbent E.
        The impact of illness perceptions and disease severity on quality of life in congenital heart disease.
        Cardiol Young. 2016; 26: 100-109
        • Baxter J.
        • Kokaua J.
        • Wells J.E.
        • McGee M.A.
        • Oakley Browne M.A.
        Ethnic comparisons of the 12 month prevalence of mental disorders and treatment contact in Te Rau Hinengaro: the New Zealand Mental Health Survey.
        Aust NZ J Psychiatry. 2006; 40: 905-913
        • Durie M.H.
        A Maori perspective of health.
        Soc Sci Med. 1985; 20: 483-486
      1. Pulotu-Endemann FK. Fonofale: Model of health. In Workshop on Pacific Health Promotion Models: A Partnership Between the Health Promotion Forum of New Zealand & Pasifika 2009. https://d3n8a8pro7vhmx.cloudfront.net/actionpoint/pages/437/attachments/original/1534408956/Fonofalemodelexplanation.pdf?1534408956. Accessed July 7, 2022

        • Barnes L.
        • Moss-Morris R.
        • Kaufusi M.
        Illness beliefs and adherence in diabetes mellitus: a comparison between Tongan and European patients.
        NZ Med J. 2004; 117: 1-9
        • Bean D.
        • Cundy T.
        • Petrie K.J.
        Ethnic differences in illness perceptions, self-efficacy and diabetes self-care.
        Psychol Health. 2007; 22: 787-811
        • Sanders D.
        • Kydd R.
        • Morunga E.
        • Broadbent E.
        Differences in patients' perceptions of schizophrenia between Māori and New Zealand Europeans.
        Aust NZ J Psychiatry. 2011; 45: 483-488
        • Broadbent E.
        • Petrie K.J.
        • Main J.
        • Weinman J.
        The brief illness perception questionnaire.
        J Psychosom Res. 2006; 60: 631-637
        • O’Donovan C.E.
        • Skinner J.R.
        • Broadbent E.
        Perceptions of risk of cardiac arrest in individuals living with a cardiac inherited disease: are the doctor and the patient on the same page?.
        Heart Lung Circ. 2020; 29: 851-858
        • Kroenke K.
        • Spitzer R.L.
        • Williams J.B.
        The PHQ-9: validity of a brief depression severity measure.
        J Gen Intern Med. 2001; 16: 606-613
        • Spitzer R.L.
        • Kroenke K.
        • Williams J.B.
        • Löwe B.
        A brief measure for assessing generalized anxiety disorder: the GAD-7.
        Arch Intern Med. 2006; 166: 1092-1097
        • Holland J.C.
        • Bultz B.D.
        The NCCN guideline for distress management: a case for making distress the sixth vital sign.
        J Natl Compr Cancer Netw. 2007; 5: 3-7
        • Horne R.
        • Weinman J.
        • Hankins M.
        The beliefs about medicines questionnaire: the development and evaluation of a new method for assessing the cognitive representation of medication.
        Psychol Health. 1999; 14: 1-24
        • Sjölander M.
        • Eriksson M.
        • Glader E.
        The association between patients’ beliefs about medicines and adherence to drug treatment after stroke: a cross-sectional questionnaire survey.
        BMJ Open. 2013; 3e003551
        • Byerly M.J.
        • Nakonezny P.A.
        • Rush A.J.
        The Brief Adherence Rating Scale (BARS) validated against electronic monitoring in assessing the antipsychotic medication adherence of outpatients with schizophrenia and schizoaffective disorder.
        Schizophr Res. 2008; 100: 60-69
        • Walter F.M.
        • Emery J.
        Perceptions of family history across common diseases: a qualitative study in primary care.
        Fam Pract. 2006; 23: 472-480
        • Affleck G.
        • Tennen H.
        • Croog S.
        • Levine S.
        Causal attribution, perceived control, and recovery from a heart attack.
        J Soc Clin Psychol. 1987; 5: 339-355
        • Hamang A.
        • Eide G.E.
        • Nordin K.
        • Rokne B.
        • Bjorvatn C.
        • Øyen N.
        Health status in patients at risk of inherited arrhythmias and sudden unexpected death compared to the general population.
        BMC Med Genet. 2010; 11: 1-10
        • Gerhardt C.A.
        • Vannatta K.
        • McKellop J.M.
        • Zeller M.
        • Taylor J.
        • Passo M.
        • et al.
        Comparing parental distress, family functioning, and the role of social support for caregivers with and without a child with juvenile rheumatoid arthritis.
        J Pediatr Psychol. 2003; 28: 5-15
        • Horton P.
        Pacific Islanders in professional rugby football: bodies, minds and cultural continuities.
        Asia Pacific J Sport Soc Sci. 2014; 3: 222-235
        • Hill S.
        • Sarfati D.
        • Blakely T.
        • Robson B.
        • Purdie G.
        • Chen J.
        • et al.
        Survival disparities in Indigenous and non-Indigenous New Zealanders with colon cancer: the role of patient comorbidity, treatment and health service factors.
        J Epidemiol Community Health. 2010; 64: 117-123
        • Tupai-Firestone R.
        • Tuisano H.
        • Manukia M.
        • Kaholokula K.
        • Foliaki S.
        • Kingi T.K.
        • et al.
        Understanding Pasifika youth and the obesogenic environment, Auckland and Wellington, New Zealand.
        NZ Med J. 2016; 129: 23-35
        • Waddell-Smith K.E.
        • Li J.
        • Smith W.
        • Crawford J.
        • Skinner J.R.
        β-Blocker adherence in familial long QT syndrome.
        Circ Arrhythm Electrophysiol. 2016; 9e003591
        • Kleinman A.
        Concepts and a model for the comparison of medical systems as cultural systems.
        Soc Sci Med-Med Anth. 1978; 12: 85-93