Metanoia Institute, Ealing, London, UK.
Palliat Support Care. 2021 Jun;19(3):367-376. doi: 10.1017/S1478951520001261.
Previous studies have shown that psychological stress and mental health problems increase the risk for cardiovascular disease (CVD) events, such as heart attack or stroke. Furthermore, after CVD events, the majority of patients report large stress. However, psychological treatments have only modest effects in CVD patients. Therefore, it has been argued that new conceptual models are needed to understand the aetiology of stress and mental health problems in CVD patients. Therefore, this study included a systematic literature review and a conceptual model on the role of meaning in life for psychological stress, mental health, and CVD risks.
A systematic literature review was conducted on relationships between CVD and meaning in life. PRISMA/MOOSE review guidelines were followed. These findings were used to build a conceptual model.
The literature review included 113 studies on meaning and CVD. The included studies described meaning as a predictor of cardiovascular risks and health, meaning-centered needs of patients in conversations with medical staff, meaning-centered changes after CVD events, meaning-centered coping with CVD, meaning as motivator of CVD-related lifestyle changes, and meaning as an element in psychological treatments of CVD patients. In sum, the literature showed that a central clinical concern for patients is their question how to live a meaningful life despite CVD. Meaning-centered concerns seem to lead to lower motivation to make lifestyle changes, more psychological stress, lower quality-of-life, worse physical well-being, and increased CVD risk. The ability to live a meaningful life after CVD events is related with lower stress, better mental health, and several biomarkers.
An evidence-based conceptual framework was developed for the relationship between meaning and CVD. It may be hypothesized CVD patients may benefit from psychological therapies focused on meaning.
先前的研究表明，心理压力和心理健康问题会增加心血管疾病（CVD）事件的风险，如心脏病发作或中风。此外，在 CVD 事件发生后，大多数患者报告存在较大压力。然而，心理治疗对 CVD 患者的效果仅适度。因此，有人认为需要新的概念模型来理解 CVD 患者心理压力和心理健康问题的病因。因此，本研究包括对生活意义在心理压力、心理健康和 CVD 风险中的作用的系统文献综述和概念模型。
对 CVD 与生活意义之间的关系进行了系统的文献综述。遵循 PRISMA/MOOSE 综述指南。这些发现被用于构建一个概念模型。
文献综述包括 113 项关于意义和 CVD 的研究。纳入的研究将意义描述为心血管风险和健康的预测因素、医务人员与患者交谈中患者的意义中心需求、CVD 事件后的意义中心变化、CVD 的意义中心应对、作为 CVD 相关生活方式改变的动机，以及作为 CVD 患者心理治疗的一个要素。总之，文献表明，患者的一个核心临床关注点是他们在患有 CVD 的情况下如何过上有意义的生活的问题。以意义为中心的关注点似乎会导致更低的生活方式改变动机、更高的心理压力、更低的生活质量、更差的身体幸福感和更高的 CVD 风险。在 CVD 事件后过上有意义的生活的能力与较低的压力、更好的心理健康和几个生物标志物有关。
为意义与 CVD 之间的关系开发了一个基于证据的概念框架。可以假设，心理治疗关注意义可能会使 CVD 患者受益。
