Prevalence and patterns of anxiety and depression in patients undergoing elective, percutaneous transluminal coronary angioplasty
Prevalence and patterns of anxiety and depression in patients undergoing elective, percutaneous transluminal coronary angioplasty
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DOI：
10.1016/j.hrtlng.2005.05.002
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发表时间：
2005-11-01
期刊：
影响因子：
2.8
通讯作者：
Thompson, DR
中科院分区：
文献类型：
--
作者：
Astin, F;Jones, K;Thompson, DR
背景：选择性经皮腔内冠状动脉成形术（PTCA）作为冠心病治疗的应用越来越多。尽管如此，对于接受和恢复这种手术的患者所经历的焦虑和抑郁的患病率和模式知之甚少。焦虑和抑郁是已知会对心脏事件后的康复产生负面影响的因素。目的：本研究的目的是(1)描述焦虑和抑郁水平：。(2)确定焦虑和抑郁与性别、婚姻状况、急性心肌梗死史和心脏康复就诊等社会人口学和临床变量之间的明显关联。方法：在这项描述性、重复测量性调查中，要求患者（n = 140）在三个时间点完成Spielberger状态特质焦虑量表和心脏抑郁量表（CDS）：(1)入院前进行选择性PTCA (T-1)；(2) PTCA术后6 ~ 8周（T-2）；(3) PTCA后6 ~ 8个月（T-3）。结果：典型的参与者为男性（75%），欧洲种族（90%），年龄62岁（标准差= 10.7），患有单或双血管疾病，过去曾参加过心脏康复治疗。在T-1阶段，16%的男性和24%的女性的焦虑状态得分与神经精神病患者相当。特质焦虑得分在一段时间内保持相对稳定；T-1评分较高与既往急性心肌梗死相关。T-2和T3的CDS评分明显低于T-1。然而，与T-2相比，CDS评分在T3出现了意想不到的增加。在T-3阶段，相对于T-1阶段，有14%的男性和10%的女性抑郁。结论：研究结果支持对这一人群的情绪状况进行更密切的监测。专业护士有可能在识别那些有焦虑和抑郁风险的人方面发挥更大的作用。然而，这种未满足的需求将一直得不到满足，除非与患者面对面接触时间最多的专科护士具备了系统地识别那些“有风险”的人的技能和资源。
BACKGROUND: The use of elective percutaneous transluminal coronary angioplasty (PTCA) as a treatment for coronary heart disease is increasing. Despite this, little is known about the prevalence and patterns of anxiety and depression experienced by patients undergoing and recovering ::nom this procedure. Anxiety and depression are factors known to negatively influence recovery after a cardiac event.OBJECTIVE: The purpose of this study was to (1) describe the levels of anxiety and depression:. reported by patients pre- and postelective PTCA, and (2) determine associations evident between anxiety and depression and the sociodemographic and clinical variables of gender, marital status, history of acute myocardial infarction, and attendance at cardiac rehabilitation. METHODS: In this descriptive, repeated-measures investigation, patients (n = 140) were requested to complete the Spielberger State Trait Anxiety Inventory and Cardiac Depression Scale (CDS) at three time points: (1) before admission for elective PTCA (T-1); (2) 6 to 8 weeks (T-2) after PTCA; and (3) 6 to 8 months (T-3) after PTCA.RESULTS: A typical participant was male (75%), of European ethnicity (90%), aged 62 years (standard deviation = 10.7) with single or double vessel disease, and had attended cardiac rehabilitation in the past. At T-1, 16% of men and 24% of women had state anxiety scores comparable to those experienced by neuropsychiatric patients. Trait anxiety scores remained relatively constant over time; higher scores at T-1 were associated with past acute myocardial infarction. CDS scores at T-2 and T3 were significantly lower than those at T-1. However, an unexpected increase in CDS scores occurred at T3, compared with T-2. At T-3, 14% of men and 10% of women were depressed, relative to T-1.CONCLUSION: The findings lend support for the closer surveillance of emotional status in this population. Specialist nurses have the potential to play a greater role in identifying those it risk of developing anxiety and depression. However, this unmet need will remain unmet until specialist nurses who spend the most face-to-face time with patients are equipped with the skills and resources to systematically identify those "at risk".