Illness perceptions and health literacy are strongly associated with health-related quality of life, anxiety, and depression in patients with coronary heart disease: results from the EUROASPIRE V cross-sectional survey.

AIMS: To (1) Describe the sociodemographic and risk factor profiles of a sample of patients with coronary disease, (2) Explore associations between illness perceptions and health literacy with sociodemographic characteristics and risk factors, health-related quality of life (HRQoL), anxiety, and depression. METHODS AND RESULTS: Conducted as part of the ESC Prevention of CVD Project and EUROASPIRE V survey, patients were consecutively and retrospectively identified 6 months to 2 years after an acute event or elective procedure from 12 countries and interviewed. Three thousand four hundred and eight participants (76% male, mean age 64 years) were recruited, 16% were smokers, 38% obese, 60% physically inactive, and 41% hypertensive. Forty percent had attended cardiac rehabilitation. More threatening illness perceptions were associated with female gender (P < 0.0001), lower income (P < 0.0001), lower education (P = 0.02), obesity (P < 0.0001), sedentary behaviour (P < 0.0001), and diabetes (P < 0.0001). Poorer health literacy was associated with obesity (P = 0.02) and sedentary behaviour (P = 0.0001). Threatening illness perceptions were strongly associated with anxiety, depression, and poorer ratings of HRQoL after multivariable adjustment (all P < 0.001). Poor health literacy was associated with anxiety and depression (P < 0.0001) and poorer ratings of HRQoL (HeartQol scores P = 0.03). Results were consistent across regions of Europe, age, gender, and socio-economic strata. CONCLUSIONS: Interventions like cardiac rehabilitation should be targeted at vulnerable groups given the strong associations between more threatening illness perceptions, lower health literacy, lower HRQoL, and higher levels of anxiety and depression. The delivery and content of these interventions should be accessible for those with low health literacy.

Short communication: a system for remote monitoring of a hospital linear accelerator.

Linear accelerators are complex machines with many parameters affecting the quality of the treatment beam delivered. A high level of technical support is required but this can be difficult to achieve if the linear accelerator is at a centre distant from a medical physics department. This paper describes a solution to this problem whereby a newly installed linear accelerator at the Royal Shrewsbury Hospital is remotely monitored from the Royal Hospital, Wolverhampton. The system enables run-up procedures to be completed by guiding radiographers at Shrewsbury through a series of steps. It consists of electronic hardware connected to the linear accelerator, under the control of a computer. The machine parameters are read and tested against preset tolerances. The monitoring system has been installed and is in routine use. The benefits have been shown to be: a saving in staff time and travel costs, the satisfactory completion of run-up procedures, a higher level of efficiency in the medical physics service provided and effective quality control. Finally, some future developments are presented. These include the development of a real time remote monitoring system that constantly monitors the linear accelerator, allowing the Medical Physics Department access to the machine parameters at any time.