Browsing by Author "Lehto, Rebecca H."

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    Emotion Regulation and Perceptions of Illness Coherence and Controllability on Regimen Adherence and Negative Cardiac Health Events in African American Women With Heart Failure
    (Wolters Kluwer, 2017) Wierenga, Kelly L.; Lehto, Rebecca H.; Given, Barbara; School of Nursing
    Background: African American women with heart failure (HF) have stressors that negatively impact HF self-management adherence and heighten the occurrence of negative cardiac health events. Perceptions of illness coherence and controllability and emotion regulation are known to facilitate self-management in the face of stressors. Objective: The aim of this study was to determine whether difficulties with emotion regulation and negative perceptions of illness coherence and controllability are detrimental to adherence and increase negative cardiac health events in this patient population. Methods: African American women (n = 54) with HF, aged 49 to 84 years, participated in this longitudinal descriptive correlational study. Using convenience sampling, we recruited patients from hospitals and HF clinics. They completed interviews at intake and 30 days, and their medical records were reviewed at 90 days. Linear and logistic regression models were used to assess predictors of general adherence and negative cardiac health events. Results: Of 54 patients who participated in the study, 28 experienced a negative health event during 90 days, and 57% of these events were cardiac related. The only clear predictor of these events was greater New York Heart Association functional classification (β = 1.47, P = .027). No associations were found between predictors (emotion regulation, controllability, coherence, age, education) and general adherence. Conclusions: Emotion regulation showed a possible greater impact on negative cardiac health events than on general adherence. Perceived illness coherence showed less impact on negative cardiac health events than on general adherence.
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    Emotion Regulation in Chronic Disease Populations: An Integrative Review
    (Springer, 2017) Wierenga, Kelly L.; Lehto, Rebecca H.; Given, Barbara; School of Nursing
    Background and Purpose: Emotion regulation, the experiencing, processing, and modulating of emotional response, is necessary to manage the emotional stressors common in patients with chronic illness. Overwhelming emotional demands deplete the resources needed for everyday self-care management of chronic disease, contributing to poor health outcomes. Emotion regulation is shown to impact behaviors in healthy individuals; yet, a review of literature examining evidence of associations in chronically ill populations is lacking. The purpose of this article is to examine the state of the science relative to the impact of emotion regulation on health outcomes in chronic illness populations. Methods: Articles were reviewed (N = 14) that focused on emotion regulation and outcomes of patients with chronic illness. Results: Indicate that most of the studies focused on these concepts are cross-sectional and measure emotion regulation using various surveys. Potential relationships exist with increased age, male gender, higher education, decreased stress, depressive, and anxiety symptoms being associated with more adaptive emotion regulation. Of primary importance to patients with chronic illnesses is the potential link between greater difficulties with emotion regulation and the presence of chronic disease as well as poorer physical function. Implications for Practice: Care should include attention to affective regulation as well as physiologic responses of chronic illness.