Arch Hellen Med, 29(1), January-February 2012, 33-43
The effects of anxiety and depression on the needs of patients hospitalized with coronary disease
M. Polikandrioti,1 I. Goudevenos,2 L. Michalis,2 S. Patsilinakos,3 V. Nikolaou,4 C. Olympios,5 C. Dilanas,6 V. Votteas,7 S. Zompolos,8 M. Elisaf9
OBJECTIVE To explore the association of anxiety and depression with the needs of patients hospitalized with coronary disease.
METHOD The study sample consisted of 702 patients hospitalized with coronary artery disease in four public hospitals in Attica and two provincial hospitals. Data were collected by the completion of a questionnaire which, in addition to demographic and clinical information included the Hospital Anxiety and Depression Scale (HADS) and a specially designed section for the assessment of patients' needs. Statistical analysis was conducted by one way analysis of variance (ANOVA) and multiple linear regression analysis, using the statistical software package SPSS, v. 17. All reported p values were based on two-sided hypotheses and compared to a significance level of 5%.
RESULTS Of the study participants, 78.3% were aged 50−80 years, 71.4% were married, 48.1% were pensioners, 48.4% had completed primary education only, and 48.3% had two children. Regarding diagnosis, 32.2% of the participants had STEMI myocardial infraction and 27.1% had heart failure, and 63.4% were following medical treatment; 49.7% had a family history of cardiovascular disease and 43.8% had another co-existing disease. According to the HADS, 25.5% of the participants were experiencing moderate levels and 32.7% high levels of anxiety, while 19.1% were experiencing moderate levels of depression and 20% high levels. Regarding the needs of the hospitalized patients in relation to their mental health, it was found that no kinds of needs were related to a statistically significant degree with anxiety. Conversely, depression was significantly associated with (a) need for support and guidance, (b) need for information from the medical-nursing staff, (c) need for being in contact with other patient groups, and ensuring communication with relatives, (d) need for individualized treatment and for personal participation to his(her) treatment, (e) need for emotional (e.g., anxiety, fear, loneliness) and physical (e.g., relaxation, sleep, better conditions during hospitalization) demands to be met, and (f ) need to trust the medical-nursing staff (p<0.001 for all). Multiple linear regression analysis revealed that depression was significantly associated with the various needs of the hospitalized patients even after controlling for age, gender, marital status, region of residence, type of cοronary artery disease, level of information and the years since the onset of the disease.
CONCLUSIONS Assessment of the needs of patients with coronary artery disease and systematic screening for anxiety and depression should be an integral part of their treatment since this allows an effective bio-psychological approach which ensures a better disease outcome.
Key words: Anxiety, Coronary artery disease, Depression, Patients' needs.