Anxiety and Depression After a Cardiac Event: Prevalence and Predictors
- Murphy, Barbara, Le Grande, Michael, Alvarenga, Marlies, Worcester, Marian, Jackson, Alun
- Authors: Murphy, Barbara , Le Grande, Michael , Alvarenga, Marlies , Worcester, Marian , Jackson, Alun
- Date: 2020
- Type: Text , Journal article
- Relation: Frontiers in Psychology Vol. 10, no. (2020), p.
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- Description: Introduction: Patients who are anxious or depressed after an acute cardiac event are at increased risk of a subsequent event and premature death. It is therefore important to identify these patients early in order to initiate supportive or even preventive measures. In the present study, we report on the prevalence of anxiety and depression during the first 12 months after an acute cardiac event, and the patient characteristics predictive of increased anxiety and depression risk in early and late convalescence. Methods: We recruited a sample of 911 patients with acute myocardial infarction (AMI), acute coronary syndrome (ACS), and/or unstable angina (UA), and/or undergoing coronary artery bypass graft surgery (CABGS). Patients completed the Hospital Anxiety and Depression Scale (HADS) close to the time of their event, and again during early (2–4 months post-event) and late (6–12 months post-event) convalescence. Using HADS-A and HADS-D cut-offs of 8+, prevalence rates for anxiety, depression, and comorbid anxiety and depression were determined for each timepoint. Chi-square tests and odds ratios were used to identify baseline patient characteristics associated with increased anxiety and depression risk over 12 months. Results: Anxiety rates were 43, 28, and 27% at the time of the event, early, and late convalescence. Depression rates were 22, 17, and 15%, respectively. Factors consistently associated with increased anxiety and depression risk were history of depression, financial strain, poor self-rated health, low socioeconomic status, younger age (<55 years), and smoking. Obesity, diabetes, and social isolation (living alone or being unpartnered) were identified as important albeit less significant risk factors. Neither sex nor event type were predictive of anxiety or depression. Conclusion: This large patient sample provided the opportunity to identify rates of anxiety and depression during the 12 months after a cardiac event and key patient characteristics for increased risk. These risk factors are easily identifiable at the time of the event, and could be used to guide the targeting of support programs for patients at risk. © Copyright © 2020 Murphy, Le Grande, Alvarenga, Worcester and Jackson.
- Authors: Murphy, Barbara , Le Grande, Michael , Alvarenga, Marlies , Worcester, Marian , Jackson, Alun
- Date: 2020
- Type: Text , Journal article
- Relation: Frontiers in Psychology Vol. 10, no. (2020), p.
- Full Text:
- Reviewed:
- Description: Introduction: Patients who are anxious or depressed after an acute cardiac event are at increased risk of a subsequent event and premature death. It is therefore important to identify these patients early in order to initiate supportive or even preventive measures. In the present study, we report on the prevalence of anxiety and depression during the first 12 months after an acute cardiac event, and the patient characteristics predictive of increased anxiety and depression risk in early and late convalescence. Methods: We recruited a sample of 911 patients with acute myocardial infarction (AMI), acute coronary syndrome (ACS), and/or unstable angina (UA), and/or undergoing coronary artery bypass graft surgery (CABGS). Patients completed the Hospital Anxiety and Depression Scale (HADS) close to the time of their event, and again during early (2–4 months post-event) and late (6–12 months post-event) convalescence. Using HADS-A and HADS-D cut-offs of 8+, prevalence rates for anxiety, depression, and comorbid anxiety and depression were determined for each timepoint. Chi-square tests and odds ratios were used to identify baseline patient characteristics associated with increased anxiety and depression risk over 12 months. Results: Anxiety rates were 43, 28, and 27% at the time of the event, early, and late convalescence. Depression rates were 22, 17, and 15%, respectively. Factors consistently associated with increased anxiety and depression risk were history of depression, financial strain, poor self-rated health, low socioeconomic status, younger age (<55 years), and smoking. Obesity, diabetes, and social isolation (living alone or being unpartnered) were identified as important albeit less significant risk factors. Neither sex nor event type were predictive of anxiety or depression. Conclusion: This large patient sample provided the opportunity to identify rates of anxiety and depression during the 12 months after a cardiac event and key patient characteristics for increased risk. These risk factors are easily identifiable at the time of the event, and could be used to guide the targeting of support programs for patients at risk. © Copyright © 2020 Murphy, Le Grande, Alvarenga, Worcester and Jackson.
Protocol for the development and validation of a measure of persistent psychological and emotional distress in cardiac patients : the cardiac distress inventory
- Jackson, Alun, Rogerson, Michelle, Le Grande, Michael, Thompson, David, Ski, Chantal, Alvarenga, Marlies, Amerena, John, Higgins, Rosemary, Raciti, Michela, Murphy, Barbara
- Authors: Jackson, Alun , Rogerson, Michelle , Le Grande, Michael , Thompson, David , Ski, Chantal , Alvarenga, Marlies , Amerena, John , Higgins, Rosemary , Raciti, Michela , Murphy, Barbara
- Date: 2020
- Type: Text , Journal article
- Relation: BMJ Open Vol. 10, no. 6 (2020), p.
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- Description: Introduction Distress is experienced by the majority of cardiac patients, yet no cardiac-specific measure of distress exists. The aim of this project is to develop and validate the Cardiac Distress Inventory (CDI). Using the CDI, health professionals will be able to identify key clusters of psychological, emotional and social concern to address with patients, postcardiac event. Methods and analysis An item pool will be generated through: identification of items by a multidisciplinary group of clinician researchers; review of generic and condition-specific distress measures; focus group testing with cardiac rehabilitation professionals; feedback from patients. The COSMIN (COnsensus-based Standards for the selection of health Measurement INstruments) criteria will be used to inform the development of the methodology for determining the CDI's psychometric properties. The item pool will be tested with 400 cardiac patients and responses subjected to exploratory factor analysis, Rasch analysis, construct validity testing and latent class analysis. Receiver operating characteristic analysis will be used to identify the optimal CDI cut-off score for distinguishing whether a person experiences clinically significant distress. Ethics and dissemination Approved by the Monash Health Human Research Ethics Committee (approval number - RES-19-0000631L-559790). The CDI will be made available to clinicians and researchers without charge. The CDI will be translated for use internationally. Study findings will be shared with cardiac patient support groups; academic and medical communities via publications and presentations; in the training of cardiac secondary prevention professionals; and in reports to funders. Authorship for publications will follow the uniform requirements for manuscripts submitted to biomedical journals. © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
- Authors: Jackson, Alun , Rogerson, Michelle , Le Grande, Michael , Thompson, David , Ski, Chantal , Alvarenga, Marlies , Amerena, John , Higgins, Rosemary , Raciti, Michela , Murphy, Barbara
- Date: 2020
- Type: Text , Journal article
- Relation: BMJ Open Vol. 10, no. 6 (2020), p.
- Full Text:
- Reviewed:
- Description: Introduction Distress is experienced by the majority of cardiac patients, yet no cardiac-specific measure of distress exists. The aim of this project is to develop and validate the Cardiac Distress Inventory (CDI). Using the CDI, health professionals will be able to identify key clusters of psychological, emotional and social concern to address with patients, postcardiac event. Methods and analysis An item pool will be generated through: identification of items by a multidisciplinary group of clinician researchers; review of generic and condition-specific distress measures; focus group testing with cardiac rehabilitation professionals; feedback from patients. The COSMIN (COnsensus-based Standards for the selection of health Measurement INstruments) criteria will be used to inform the development of the methodology for determining the CDI's psychometric properties. The item pool will be tested with 400 cardiac patients and responses subjected to exploratory factor analysis, Rasch analysis, construct validity testing and latent class analysis. Receiver operating characteristic analysis will be used to identify the optimal CDI cut-off score for distinguishing whether a person experiences clinically significant distress. Ethics and dissemination Approved by the Monash Health Human Research Ethics Committee (approval number - RES-19-0000631L-559790). The CDI will be made available to clinicians and researchers without charge. The CDI will be translated for use internationally. Study findings will be shared with cardiac patient support groups; academic and medical communities via publications and presentations; in the training of cardiac secondary prevention professionals; and in reports to funders. Authorship for publications will follow the uniform requirements for manuscripts submitted to biomedical journals. © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
- Murphy, Barbara, Zaman, Sarah, Tucker, Kim, Alvarenga, Marlies, Morrison-Jack, Jenni, Higgins, Rosemary, Le Grande, Michael, Nasis, Arthur, Jackson, Alun
- Authors: Murphy, Barbara , Zaman, Sarah , Tucker, Kim , Alvarenga, Marlies , Morrison-Jack, Jenni , Higgins, Rosemary , Le Grande, Michael , Nasis, Arthur , Jackson, Alun
- Date: 2021
- Type: Text , Journal article
- Relation: European Journal Cardiovascular Nursing Vol. 20, no. 7 (2021), p. 633-640
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- Description: Despite its demonstrated benefits, cardiac rehabilitation (CR) attendance, and completion is suboptimal, particularly in women. The aims of this study were (i) to develop and pilot test a women-only yoga-based CR programme (the Women's Yoga CR Programme WYCRP) (ii) to investigate programme acceptability and (iii) to investigate attendance and completion of the WYCRP and continuation to Phase III community-based CR. Women eligible for CR at a tertiary hospital in Melbourne, Australia were recruited. Over a 6-month period in 2019, they were offered the WYCRP or usual CR. The WYCRP involved attendance at a 1-h yoga session following the usual 1-h mixed-sex education session, over a 7-week period. Participants completed pre- and post-programme questionnaires and attended focus groups to assess programme acceptability. Rates of attendance, completion, and continuation for the WYCRP were recorded and compared to those for the standard CR programme offered in 2018. In total, 27 women were eligible for the study and attended the initial CR assessment. Of those, 22 (81%) attended the WYCRP, 1 (4%) attended usual CR, and 4 (15%) did not attend CR. Ratings of programme acceptability were consistently positive qualitative comments highlighted both physical and emotional benefits. While attendance at the WYCRP was not significantly higher than for usual CR the previous year (81% vs. 76% P = 0.40), CR completion, and continuation were (95% vs. 56% P = 0.02, and 72% vs. 12% P < 0.001, respectively). This pilot study has demonstrated that women-only yoga-based CR is appealing to women and can improve women's CR completion and continuation. These preliminary findings support further development of women-only and yoga-based CR options.
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