Psychological distress and health perception in patients with a previous myocardial infarction or stroke: a national cross-sectional study.

BACKGROUND: While understanding the impact of mental health on health perception improves patient-centered care, this relationship is not well-established in patients with cardiovascular disease (CVD). We examined the relationship between psychological distress and health perception in patients with a previous myocardial infarction (MI) and/or stroke. METHODS: We extracted data for patients with a previous MI and/or stroke from the 2019 National Health Interview Survey (NHIS). Health perception was self-reported. Presence and severity of anxiety and depression were estimated using the Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-8 (PHQ-8). Binary analyses of anxiety/depression, multivariable logistic regressions controlling for confounders, and univariable analyses of confounders and anxiety/depression severity were performed. RESULTS: Of 31,948 individuals for whom data on MI/stroke was available, 1235 reported a previous MI and 1203 a previous stroke. The odds of positive perceived health status were lower for individuals with anxiety/depression compared to those without anxiety/depression in both post-MI (anxiety OR 0.52, 95% CI = 0.32-0.85, P < 0.001; depression OR 0.45, 95% CI = 0.29-0.7, P < 0.001) and post-stroke groups (anxiety OR 0.61, 95% CI = 0.39-0.97, P < 0.001; depression OR 0.37, 95% CI = 0.25-0.55, P < 0.001) upon multivariable analyses. Increasing severity of anxiety/depression was also associated with worse perception of health status upon univariable analysis. CONCLUSION: Among patients with a previous acute CVD event, those with psychological distress have worse perception of their health status. Understanding the range of patient health perceptions can help physicians provide more patient-centered care and encourage patient behaviors that may improve both CVD and mental health outcomes.

Declutter and Focus: Empirically Evaluating Design Guidelines for Effective Data Communication.

Data visualization design has a powerful effect on which patterns we see as salient and how quickly we see them. The visualization practitioner community prescribes two popular guidelines for creating clear and efficient visualizations: declutter and focus. The declutter guidelines suggest removing non-critical gridlines, excessive labeling of data values, and color variability to improve aesthetics and to maximize the emphasis on the data relative to the design itself. The focus guidelines for explanatory communication recommend including a clear headline that describes the relevant data pattern, highlighting a subset of relevant data values with a unique color, and connecting those values to written annotations that contextualize them in a broader argument. We evaluated how these recommendations impact recall of the depicted information across cluttered, decluttered, and decluttered+focused designs of six graph topics. Undergraduate students were asked to redraw previously seen visualizations, to recall their topics and main conclusions, and to rate the varied designs on aesthetics, clarity, professionalism, and trustworthiness. Decluttering designs led to higher ratings on professionalism, and adding focus to the design led to higher ratings on aesthetics and clarity. They also showed better memory for the highlighted pattern in the data, as reflected across redrawings of the original visualization and typed free-response conclusions, though we do not know whether these results would generalize beyond our memory-based tasks. The results largely empirically validate the intuitions of visualization designers and practitioners. The stimuli, data, analysis code, and Supplementary Materials are available at https://osf.io/wes9u/.