Anxiety and Depression in Hospitalized Patients with Coronary Artery Disease or with an Implantable Cardioverter-Defibrillator

Abstract

Introduction: Anxiety and depression appear to be frequent symptoms among patients with coronary artery disease (CAD) and patients with an implantable cardioverter-defibrillator (ICD), affecting not only the progression of the disease but also the socioeconomic affairs of patients and their families. Purpose: The aim of the present study was to assess hospital anxiety and depression in patients with CAD and/or an ICD in a Greek regional hospital. Material and Method: This is a synchronous cohort study with partial correlation analysis, carried out in the Cardiology Department of a University Hospital of the Greek region between November 2013 to March 2014. In the study, 121 hospitalized cardiac patients with coronary artery disease or implantable cardioverter defibrillator (60% response rate) were selected by purposive sampling method. Data were collected using the Hospital Anxiety and Depression Scale (HADS). Frequency distributions were calculated for the characteristics of the participating patients. Descriptive statistics have been applied and non-parametric criteria were use , such as Spearman’s rank correlation coefficient, and the Mann-Whitney test to differentiate between patients with (CAD) and/or (ICD). Categorical data were analysed using a chi-square test. The significance level was set at a= 0.05. Results: 94 (77.7%) of the sample were male and 27 (22,3%) female. Out of 121 patients participated in the current study, 34.7% (42 individuals) had an ICD, 35.5% (43 individuals) did not, while 29.8% (36 individuals) did not answer. On the HADS scale, mean anxiety is 7.4±3,1 and Cronbach’s alpha was found 0.550 considered relatively low , while mean depression was 5.3±4,2 and Cronbach’s alpha was 0.833. 27.5% of participants present inconclusive results regarding anxiety symptoms and 18.3% present definite anxiety symptoms. Respectively, 12.5% present inconclusive results concerning depression’s symptoms while 11.7% present clear symptoms of depression. No statistically significant difference was found between patients with or without an ICD. Conclusions: Results indicate that 1/5 of patients present symptoms of anxiety and 1/10 present symptoms of depression, while a low percentage have both anxiety and depression. The assessment of anxiety and depression levels in hospital patients with CAD needs to be incorporated into clinical nursing practice in order to prevent these psychological conditions from affecting patients’ quality of life and disease progression.