Department of Internal Medicine (Cardiovascular Medicine).
Department of Psychiatry.
Health Psychol. 2022 Oct;41(10):779-791. doi: 10.1037/hea0001152. Epub 2022 Feb 24.
Cardiovascular disease remains the leading cause of morbidity and mortality in industrialized nations. Many patients living with chronic cardiovascular disease suffer from complex multimorbidities requiring high-intensity care and behavioral risk factor management, and about a third copresent with a mental health disorder. These comanifestations are extremely taxing for patients and our health care system, complicate treatment, and increase the risk of adverse health outcomes. Health psychology emerged in response to a need for specialists who could design, deliver, and test evidence-based approaches to manage behavioral risk factors and the mental health burden of chronic diseases. We aimed to conduct a state-of-the-art review as to how health psychology emerged as a key specialty in delivering integrated care for cardiovascular populations, and to review challenges and opportunities that lie ahead of further integration of the specialty for integrated cardiovascular care.
As our health care system embraces more patient-centered care and big data science to detect at-risk patients and predict outcomes, health psychologists should be at the forefront to apply their expertise and demonstrate their value in designing and applying intervention models to improve outcomes. We first review challenges, then illustrate this framework using the Wagner chronic care model, present business case considerations, and conclude with an action agenda to promote the integration of health psychology as a cotreating specialty into cardiovascular care.
To provide direction for this undertaking, we present a roadmap for the field of health psychology to sustainably extend existing holistic, integrated approaches in cardiovascular care.
To lessen the burden and improve outcomes in cardiovascular disease, care must shift away from siloed delivery models that are focused on traditional atherosclerotic risk factors to holistic, integrated approaches that address biological, psychological, social, and behavioral factors relevant to cardiovascular disease. Using the presented roadmap, health psychology can play a major role to address these needs of integrated cardiovascular care. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
心血管疾病仍然是工业化国家发病率和死亡率的主要原因。许多患有慢性心血管疾病的患者患有需要高强度护理和行为风险因素管理的复杂多种合并症，约三分之一的患者同时患有精神健康障碍。这些合并症对患者和我们的医疗保健系统造成了极大的负担，使治疗变得复杂，并增加了不良健康结果的风险。健康心理学的出现是为了满足需要专门人员的需求，这些人员可以设计、提供和测试基于证据的方法来管理行为风险因素和慢性病的精神健康负担。我们旨在对健康心理学如何作为为心血管人群提供综合护理的关键专业而出现进行最先进的综述，并审查进一步整合该专业以进行综合心血管护理所面临的挑战和机遇。
随着我们的医疗保健系统采用更多以患者为中心的护理和大数据科学来发现高危患者并预测结果，健康心理学家应该处于应用其专业知识并展示其在设计和应用干预模型以改善结果方面的价值的最前沿。我们首先审查挑战，然后使用 Wagner 慢性病护理模型说明该框架，提出商业案例考虑因素，并以促进健康心理学作为共同治疗专业纳入心血管护理的行动计划结束。
为了为这项工作提供指导，我们为健康心理学领域提出了路线图，以可持续地扩展心血管护理中现有的整体综合方法。
为了减轻心血管疾病的负担并改善结果，护理必须从关注传统动脉粥样硬化风险因素的孤立式交付模式转移到整体综合方法，以解决与心血管疾病相关的生物、心理、社会和行为因素。使用提出的路线图，健康心理学可以在解决综合心血管护理的这些需求方面发挥重要作用。
