A Network Analysis of the Association Between Depressive Symptoms and Patient Activation Among Those With Elevated Cardiovascular Risk

[摘要] Background: Network analysis provides a new method for conceptualizing interconnections among psychological andbehavioral constructs.Objective: We used network analysis to investigate the complex associations between depressive symptoms and patientactivation dimensions among patients at elevated risk of cardiovascular disease.Methods: This secondary analysis included 200 patients seen in primary care clinics. Depressive symptoms were assessed usingthe 21-item Beck Depression Inventory. Patient activation was measured using the 13-item Patient Activation Measure. Glassonetworks were constructed to identify symptoms/traits that bridge depressive symptoms and patient activation and those thatare central within the network.Results: “Self-dislike” and “confidence to maintain lifestyle changes during times of stress” were identified as important bridgepathways. In addition, depressive symptoms such as “punishment feelings,” “loss of satisfaction,” “self-dislike,” and “loss ofinterest in people” were central in the depressive symptom–patient activation network, meaning that they were most stronglyconnected to all other symptoms.Conclusions: Bridge pathways identified in the network may be reasonable targets for clinical intervention aimed at disruptingthe association between depressive symptoms and patient activation. Further research is warranted to assess whether targetinginterventions to these central symptoms may help resolve other symptoms within the network.

[学科分类] 林业科学

[关键词] network analysis;cardiac risk;depressive symptoms;patient activation;primary care