Current Programs

Anxiety, distress and depression 

A heart event is an emotional experience, not just a physical one. Experiences of anxiety, distress and depression are common in cardiac patients. Our past research in this area has demonstrated that symptoms of distress or depression are highest close to the time of the acute event: for most patients, the initial symptoms of distress resolve in the first few months, whereas for others depression is still evident even 12 months later. We have several projects currently underway focusing on this important program of research.

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Childhood heart disease

Childhood heart disease places families under strain as they adjust to their child’s condition and strive to manage changed family circumstances. We are currently working with HeartKids Australia to improve the lives of families affected by childhood heart disease. Our initial projects in this important area are focusing on the development of an innovative program to support parents as they cope with their child’s heart condition.

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Patient self-management 

Lifestyle change is difficult.  Even amongst patients who initiate changes, longterm maintenance of new health behaviours is rare. With funding from Australian Rotary Health, we developed the Beating Heart Problems program for patients based on the self-management model, using principles of motivational interviewing and cognitive behaviour therapy. This 8-session modulated program addresses physical activity, dietary change, smoking cessation, and medication adherence, depression, anxiety, anger and social isolation. A randomised controlled trial of the program involving 275 cardiac patients demonstrated substantial improvements in physiological, behavioural and psychosocial risk factors compared to usual care. Because some patients prefer home-based learning options, we then translated the program into two alterntive formats: 'Back on Track' an online program, and 'Teleheart' a telephone-delivered program. Both programs are similarly designed to support patients in their behavioural and emotional recovery after a heart event. 

Recent Australian audits show that many health professionals lack the knowledge and/or skills to incorporate self-management and patient-centred care into practice. Targeted training of cardiac rehabilitation (CR) professionals is required to support the integration of a self-management and patient-centred approach within CR programs. With funding from the Commonwealth Department of Health and Ageing, we developed a face-to-face training program for health professionals based on self-management and patient-centred care principles. We then translated the program into an online training program – Supporting chronic disease self-management – which has now been completed by several thousand health professionals working in CR and other clinical settings in Australia.

 

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Screening and assessment 

Screening and assessment of cardiovascular risk factors is a vital step in effective cardiac rehabilitation and prevention of secondary cardiac events. While clinical risk factors such as blood pressure and cholesterol are monitored routinely during most medical consultations, psychosocial factors such as depression and social isolation are not routinely assessed. The National Heart Foundation of Australia consensus statement, released in 2013, recommends routine screening for depression at the time of a cardiac event and on multiple occasions in the 12-months post-event. This program of research focuses on this important area of screening, assessment and monitoring, with attention to measurement tools and methods. 

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Sleep disorders 

There is mounting evidence that both insufficient and excessive sleep duration are independent risk factors for cardiovascular disease (CVD). In overseas studies, sufficient sleep duration has been shown to halve the risk of fatal CVD. We are currently undertaking a suite of studies in this important areas of research. 

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Physical activity and sedentary behaviour 

Physical inactivity and sedentary behaviour are both independent risk factors for the development and progression of cardiovascular disease. We have published several papers investigating various aspects of physical activity, and have recently shifted our focus to include studies of sedentary behaviour. We currently have two studies underway in this area. 

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Positive psychology 

While much of the psychosocial literature in the cardiac area focuses on challenges faced by patients, there has recently been a shift from ‘surviving to thriving’. What are the personality characteristics that enable some patients to benefit and even grow from a life-threatening event? How can we support patients not only to survive but to thrive after an acute event? These are some of the questions we are attempting to answer in this important area of research. 

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