Fear of recurrence
Written by Dr Stephanie Mathews, ACHH Clinical Psychologist
Almost everyone who has had a cardiac event will, from time to time, worry about having another one. While this is typical during recovery, for some people these thoughts and worries can become a persistent problem. Some people ruminate about having another event or trying to avoid having another event. As part of this worry, some heart event survivors develop extreme attention to bodily sensations. This is termed ‘threat monitoring’, which refers to increased attention to signs of another possible heart attack. While some threat monitoring is useful and adaptive, excessive monitoring can contribute to heightened fear of recurrence, and can exacerbate low mood.
After a cardiac event, there is a plethora of information for patients and carers to receive and understand. We know that patients with acute or chronic illnesses have difficulty in understanding recurrence and prognostic information (Lobb et al., 1999) and have difficulty retaining this information (Tattersall & Butow, 2002). Misunderstandings and difficulties recalling information can contribute to fear of recurrence and hypervigilance of physical symptoms.
Medical professionals can help to reduce fear of recurrence by providing information about a range of factors, including: how to deal with the presence of new physical symptoms; recommended frequency of follow-up appointments and rationale for this recommendation; and guidelines for when to seek medical advice for suspected recurrence. It is important to elicit the patient’s understanding of information and provide immediate corrective feedback about any misunderstandings. Patients can also be encouraged to record information, either in audio or written form.
Our Cardiac Counselling Clinic provides specialist psychological support for those experiencing fear of recurrence following a cardiac event. For more information on how we can help your patients, please call us on 03 9326 8544 or visit our clinic page australianhearthealth.org.au/cardiac-counselling-clinic
References
Lobb, E., et al., (1999). Communicating prognosis in early breast cancer: Do women understand the language used? Medical Journal of Australia, 171, 290- 294.
Tattersall, M. & Butow, P. (2002). Consultation audio tapes: An underused cancer patient information aid and clinical research tool. Lancet Oncology, 3, 431-437.
Training Update
Our flagship program is back in 2021
We are excited to confirm that our flagship Cardiac Rehabilitation and Secondary Prevention Training Program is set to run in November this year.
As Melbourne’s COVID-19 situation remains fluid and unpredictable, particularly for those travelling regionally and interstate, we have made the decision to convert our Training Program exclusively to online delivery. By investing in exclusive online delivery we will ensure that the quality of our course remains at the highest standard.
The program will run over 4 days, with an additional day of online learning prior to attendance at the live program.
To date we have around 50 registrations for the training program, with additional spots still available.
The training attracts 30 hours of CPD points. Please email us at training@australianhearthealth.org.au for more information or register online.
Date: 15-18 November (live) plus one day of online learning pre-program
Times: 8.30am – 4.00pm
Venue: Online, links to be provided
Cost: $925 Over 30% off our usual price of $1,400
CPD hours: 30 hours
The course addresses both theoretical and practice aspects of cardiac rehabilitation and secondary prevention programs. It teaches practical skills to assist metropolitan and rural practitioners to implement, conduct and evaluate their rehabilitation and prevention programs. Sessions are delivered by a multi-disciplinary team of expert facilitators including a cardiologist, nurse, physiotherapist, psychologist, dietitian and social worker.
Topics include:
Foundations of CR Overview of CR in Australia, evidence for CR, enhancing CR access, evaluating your CR program, and the importance of inter-disciplinary care
Medical Anatomy and pathology, cardiac risk factors, medications, investigations and interventions
Psychological Managing anxiety, depression, distress and the cardiac blues in clinical practice
Behaviour change Supporting behaviour change and patient self-management
Research Update
Back on Track Project
We are very pleased to let you know that we have now completed our participant recruitment for our Back on Track Trial. Many of our participants have been directly referred to this study by those of you working with cardiac patients in cardiac rehabilitation programs, hospitals and other settings.
Our sincere thanks to all of you who referred your patients and clients to be involved in this study. After 18 months of recruitment, we have 120 participants in the study, which was our target sample. Many of them have now completed all aspects of the study, including a baseline questionnaire, 2-months access to the Back on Track online support program, an exit-questionnaire, and a 6-month follow-up questionnaire. Some participants are still part-way through this process.
All our participants will have completed the study by February next year. We will then start the exciting process of analysing the data and preparing a report on the study findings. We are very grateful to the HCF Research Foundation for their generous financial support for this study.
Now that recruitment for the study is complete, you can refer your patients and clients directly to the Back on Track program here. They will be given lifelong access to the online support program.
Cardiac Distress Study
You can also refer your patients and clients to participate in our Cardiac Distress Study. The Cardiac Distress Study aims to understand more about the range of emotions that cardiac event survivors experience during their recovery. Participants are asked to complete a one-off online anonymous questionnaire, which takes about 15-20 minutes to do.
You can find out more about the Cardiac Distress study and access the questionnaire by clicking here.
With the information we gather through the Cardiac Distress Study we will develop a new clinical measure, the Cardiac Distress Inventory. This will be of enormous benefit in our work as we help cardiac patients adjust successfully after their heart event.
The Cardiac Distress Study is part of our broader research program on Cardiac Emotions. We are partnering with Stanford University in the US, University of Suffolk in the UK, and Monash and Barwon Health in Victoria, making this an important international study.
Thank you to those of you who have already referred your patients and clients to participate in this study. So far, almost 330 heart event survivors have participated in this important research.
