Sulong @Abdul Razak, Zatul Rathiah
(2016)
Psychological status among acute coronary syndrome patients in Hospital Universiti Sains Malaysia, Kelantan and Hospital Sultanah Nur Zahirah, Terengganu.
Masters thesis, Universiti Sains Malaysia.
Abstract
INTRODUCTION: Coronary heart disease is the most common form of
cardiovascular disease and frequently manifests as acute coronary syndrome (ACS)
which includes a range of clinical conditions from angina pectoris, unstable angina,
non-ST elevation myocardial infarction to ST elevation myocardial infarction. The ACS
is a common cause of emergency hospital admission and a major burden on health care
resources in industrialized countries including Malaysia. Depression, anxiety and stress
occur at high rates among patients suffering an ACS. The depression, anxiety and stress
symptoms appear to adversely affect in-hospital and long term cardiac outcomes of
post-ACS patients. Despite their high prevalence and serious impact, the psychological
symptoms are commonly unrecognized and untreated in most ACS patients. This study
was to investigate the psychological status of ACS patients and to establish the
associated factors that contribute to it.
OBJECTIVES: To determine the prevalence and its associated factors of depression,
anxiety and stress condition of acute coronary syndrome patients in Hospital Universiti
Sains Malaysia and Hospital Sultanah Nur Zahirah.
METHODOLOGY: A cross-sectional prospective study for ten months duration was
done from August 2014 until May 2015 on eligible subjects of ACS patients in Hospital
USM and HSNZ. A questionnaire consists of two sections (socio-demographic data andDepression, Anxiety and Stress Scale 21) was used in this study. The questionnaire was
distributed to all ACS patients admitted to wards. The prevalence of depression, anxiety
and stress and their associated factors was analyzed using SPSS software version 22
(IBM Corp, 2013).
RESULTS: There were 400 patients enrolled into the study during the study period.
The prevalence of depression, anxiety and stress were 80.3%, 85.8% and 58.5%
respectively. There were significant associations between gender, ischemic heart disease
and other co-morbid with depression [p=0.000, OR 2.545(1.525, 4.248); p=0.003, OR
2.301(1.317, 4.021) and p=0.032, OR 2.297(1.076, 4.904)]. There was significant
association between ischemic heart disease and anxiety [p=0.013, OR 2.202(1.185,
4.093)]. There was significant association between ischemic heart disease and stress [p
= 0.010, OR 1.730 (1.139, 2.626)]. There were no statistically significant associations
between other demographic factors with depression, anxiety or stress.
CONCLUSION: We concluded that the prevalence of depression, anxiety and stress
were high in ACS patients. The recognized significant associated factors were gender,
ischemic heart disease and other co-morbids. Subjects who had other co-morbids and
female gender were more likely to have depression. Subjects with ischemic heart
disease were more likely to have depression, anxiety and stress.
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