Nurs Crit Care. 2021 Nov 11; doi: 10.1111/nicc.12730. Epub 2021 Nov 11.
Distress among hospitalized patients with acute coronary syndrome.
Nursing in critical care
Freda DeKeyser Ganz, Ofra Raanan, Gennady Shafir, Dassy Levy, Robert Klempfner, Roy Beigel, Zaza Iakobishvili
Affiliations
Affiliations
- Faculty of Life and Health Sciences, Jerusalem College of Technology, Jerusalem, Israel.
- Hadassah-Hebrew University School of Nursing, Jerusalem, Israel.
- Sheba Medical Center School of Nursing, Tel Hashomer, Israel.
- Cardiac Intensive Care Unit, Haemek Medical Center, Afula, Israel.
- Division of Cardiology, Rambam Medical Center, Haifa, Israel.
- Department of Cardiology, Sheba Medical Center, Cardiac Rehabilitation Institute, Tel Hashomer, Israel.
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
- Department of Cardiology, Sheba Medical Center, Tel Hashomer, Israel.
- Department of Community Cardiology, Clalit Health Services, Tel Aviv, Israel.
- Department of Cardiology, Samson Assuta Ashdod University Hospital, Ashdod, Israel.
PMID: 34766409
DOI: 10.1111/nicc.12730
Abstract
BACKGROUND: Previous studies have demonstrated that those suffering from acute coronary syndrome (ACS) experience various physical and psychological symptoms. Few studies have investigated the multi-factorial, holistic, unpleasant experience of distress that includes physical, psychological, social, and spiritual factors among this patient population while still hospitalized.
AIM: To describe the level of distress among patients hospitalized with ACS and its association with demographic and clinical factors and mortality.
STUDY DESIGN: The study conducted a descriptive, cross-sectional survey.
METHODS: The Acute Coronary Syndrome Israel Study is a national, biennial registry, enrolling all patients with ACS admitted to cardiac intensive care or cardiology wards in Israel within a 2-month period. Demographic and clinical data were retrieved from an electronic database. Distress was measured by the Distress Thermometer. Nurses collected distress data directly from patients before discharge.
RESULTS: Nine hundred ninety participants (50.6% response rate) were surveyed. Mean age was 62.8 (SD = 12.5). Mean distress level was 4.8 (SD = 3.45) out of 10. The most frequently reported area of distress was physical, followed by emotional. Practical and family problems were less frequent. Emotional distress was found to differ based on educational level, marital status, smoking history, and previous medical history. Distress did not predict 7- or 30-day mortality.
CONCLUSIONS: Respondents with ACS were in moderate distress. It is recommended that those at increased risk receive increased monitoring of emotional distress while still in hospital. Further studies should investigate this holistic view of distress among the ACS population using a variety of methods and methodologies.
© 2021 British Association of Critical Care Nurses.
Keywords: acute coronary syndrome; cardiac intensive care unit; distress
References
- Virani SS, Alonso A, Aparico HJ et al. Heart disease and stroke statistics-2021 update. A report from the American Heart Association. Circulation 2021; 143: e254-e743 - PubMed
- British Heart Foundation. UK fact sheet. Retrieved 4/5/2. https://www.bhf-cvd-statistics-uk-factsheet.pdf - PubMed
- Sanchis-Gomar F, Perez-Quilis C, Leischik R. Epidemiology of coronary heart disease and acute coronary syndrome. Ann Transl Med. 2016;4(13):256-268. - PubMed
- Vedanthan R, Seligman B, Fuster V. Global perspective on acute coronary syndrome: a burden on the young and poor. Circ Res. 2014;114:1959-1975. - PubMed
- American College of Cardiology. 2020. Acute coronary syndromes. Retrieved from https://www.acc.org/education-and-meetings/products-and-resources/guideline-education/acute-coronary-syndromes. - PubMed
- Rosengren A, Hawken S, Ôunpuu S, et al. Association of psychosocial risk factors with risk of acute myocardial infarction in 11 119 cases and 13 648 controls from 52 countries (the INTERHEART study): case-control study. Lancet. 2004;364:953-962. - PubMed
- Lal NN, Ahuja RC. Perception of distress by patients of myocardial infarction. Indian J Psych. 1987;29(3):259-262. - PubMed
- Princip M, Gattlen G, Meister-Langraf RE. The role of illness perception and its association with posttraumatic stress at 3 months following acute myocardial infarction. Front Psych. 2018;9:941. - PubMed
- Lissåker CT, Wallert J, Held C, Olsson E. Emotional distress as a predictor of statin non-adherence among Swedish first-time myocardial infarction patients, 2006-2013. J Psychosom Res. 2017;97:30-37. - PubMed
- Ossola P, Gerr ML, De Panfilis C, et al. Anxiety, depression, and cardiac outcomes after a first diagnosis of acute coronary syndrome. Health Psychol. 2018;37(12):1115-1122. - PubMed
- Lichtman JH, Froelicher ES, Blumenthal JA, et al. Depression as a risk factor for poor prognosis among patients with acute coronary syndrome: systematic review and recommendations: a scientific statement from the American Heart Association. Circulation. 2014;129(12):1350-1369. - PubMed
- National Comprehensive Cancer Network. 2020. NCCN distress thermometer and problem list. Retrieved from https://www.nccn.org/about/permissions/thermometer.aspx. - PubMed
- Mitchell AJ, Morgan JP, Petersen D, et al. Validation of simple visual-analogue thermometer screen for mood complications of cardiovascular disease: the emotion thermometers. J Affective Disorders. 2012;136(3):1257-1263. - PubMed
- Lador A, Hasdai D, Mage A, et al. Incidence and prognosis of pericarditis after ST-elevation myocardial infarction (from the acute coronary syndrome Israeli survey 2000 to 2013 registry database). Am J Cardiol. 2018;121(6):690-694. - PubMed
- MRM SG, Aaltonen L-M, Rihkanen H. (2017). Validation of the distress thermometer and problem list in patients with recurrent respiratory papillomatosis. Otolaryngol Head Neck Surg. 156(1):180-188. - PubMed
- Tuinman MA, Gazendam-Donofrio SM, Hoekstra-Weebers JE. (2008). Screening and referral for psychosocial distress in oncologic practice. Cancer. 113(4):870-878. - PubMed
- Brislin RW. Back-translation for cross-cultural research. J Cross-Cultural Psych. 1970;1(3):185-216. - PubMed
- Lavie CJ, Sui X, Milani RV. Emotional distress after myocardial infarction: importance of cardiorespiratory fitness. Eur J Preventive Cardiol. 2018;25(9):906-909. - PubMed
- Norlund F, Lissake F, Wallert J, et al. Factors associated with emotional distress in patients with myocardial infarction: results from the SWEDEHEART registry. Eur J Preventive Cardiol. 2018;25(9):910-920. - PubMed
- von Känel R, Hari R, Schmid J-P, Saner H, Begré S. Distress related to myocardial infarction and cardiovascular outcome: a retrospective observational study. BMC Psychiatry. 2011;11:98. - PubMed
- Kala P, Hudakova N, Jurajda M, et al. Depression and anxiety after acute myocardial infarction treated by primary PCI. PLoS One. 2016;11(4):e0152367. doi:10.1371/journal.pone.0152367 - PubMed
- Schultz WM, Hayek SS, Tahhan AS, et al. Marital status and outcomes in patients with cardiovascular sisease. J Am Heart Assoc. 2017;6:e005890. doi:10.1161/JAHA.117.005890 - PubMed
- Manfredini R, De Giorgi A, Tiseo R, et al. Marital status, cardiovascular diseases, and cardiovascular risk factors: a review of the evidence. J Women's Health. 2017;26(6):624-632. - PubMed
- Wong CW, Kwok CS, Narain A, et al. 2018. Marital status and risk of cardiovascular diseases: a systematic review and meta-analysis. Heart. 2018;104:1937-1948. - PubMed
- Aye WT, Lien L, Stigum H, Win HH, Oo T, Bjertness E. The prevalence of mental distress and the association with education: a cross-sectional study of 18-49-year-old citizens of Yangon Region, Myanmar. BMC Public Health. 2020;20:94. - PubMed
- St-Pierre M, Sinclair A, Elgbeil G, et al. Relationships between psychological distress and health behaviors among Canadian adults: differences based on gender, income, education, immigrant status, and ethnicity. SSM Popul Health. 2019;7:100385. - PubMed
- Ross CE, Zhang W. Education and psychological distress among older Chinese. J Aging Health. 2008;20(3):273-289. - PubMed
- Brännlund A, Hammarström A. Higher education and psychological distress: a 27-year prospective cohort study in Sweden. Scand J Public Health. 2014;42:155-162. - PubMed
- Halvorsen JF, Sund AM, Zeltzer L, et al. Health-related quality of life and psychological distress in young adult survivors of childhood cancer and their association with treatment, education, and demographic factors. Qual Life Res. 2018;27:529-537. - PubMed
- Mandemakers JJ, Monden CWS. Does education buffer the impact of disability on psychological distress? Soc Sci Med. 2010;71:288-297. - PubMed
- Denollet J. DS14: standard assessment of negative affectivity, social inhibition, and type D personality. Psychosom Med. 2005;67:89-97. - PubMed
- Pillai AG, Menon V, Satheesh S. Prevalence and correlates of type D personality among survivors following acute myocardial infarction in a tertiary care center in South India. J Neurosci Rural Pract. 2019;10:405-412. - PubMed
- Martens EJ, Mol F, Burg MM, et al. Type D personality predicts clinical events after myocardial infarction, above and beyond disease severity and depression. J Clin Psychiatry. 2010;71(6):778-783. - PubMed
- Conde´n E, Rosenblad A, Wagne P, et al. Is type D personality an independent risk factor for recurrent myocardial infarction or all-cause mortality in post-acute myocardial infarction patients? Eur J Preventive Cardiol. 2017;24(5):522-533. - PubMed
- Imbalzano E, Vatrano M, Quartuccio S, et al. Effect of type D personality on smoking status and their combined impact on outcome after acute myocardial infarction. Clin Cardiol. 2017;41:321-325. - PubMed
- Batty GD, Russ TC, Stamatakis E, Kivimäki M. Psychological distress and risk of peripheral vascular disease, abdominal aortic aneurysm, and heart failure: pooling of sixteen cohort studies. Atherosclerosis. 2014;236:385-388. - PubMed
- Juth V, Chan MK, Cramer SC, Holman EA. Assessing acute psychological distress in the immediate aftermath of stroke. Eur J Cardiovascular Nurs. 2018;17(2):186-189. - PubMed
- Lazzarino AI, Hamer M, Stamatkas E, et al. Low socioeconomic status and psychological distress as synergistic predictors of mortality from stroke and coronary heart disease. Psychosom Med. 2013;75:311-316. - PubMed
Publication Types
Grant support