Akut Koroner Sendromlu Hastalarda Anksiyete ve Depresyonu Belirleyen Faktörler

Öz

Amaç: Akut koroner sendromu olan hastalarda, anksiyete ve depresyon sık karşılaşılan ve kardiyak rehabilitasyon sürecini etkileyen sağlık sorunlarıdır. Bu çalışmada; akut koroner sendromlu hastalarda anksiyete ve depresyon düzeyini belirleyen faktörlerin araştırılması amaçlandı.

Yöntemler: Çalışmaya akut koroner sendrom tanısı ile koroner bakım ünitesinde izlenen 50 hasta (42 erkek, 8 kadın) katıldı. Olguların fiziksel, fizyolojik ve demografik özellikleri kaydedildi. Akut Koroner Olaylarda Küresel Kayıt (GRACE) risk puanı hesaplandı. Fonksiyonel düzey, New York Kalp Birliği (NHYA) sınıflaması ile belirlendi. Anksiyete düzeyi, Durumluk ve Sürekli Kaygı Envanteri (STAI); depresyon düzeyi Beck Depresyon Envanteri (BDI) kullanılarak belirlendi. Bilişsel fonksiyonlar, Mini-Mental Durum Değerlendirmesi (MMSE) kullanılarak değerlendirildi.

Sonuçlar: Çoklu doğrusal regresyon analizine göre, BDI ve NYHA sınıfı, STAI-Sürekli Anksiyete puanındaki değişimin % 45’ini açıkladı (p=0.016). Eğitim süresi, önceden geçirilmiş perkütan girişimin varlığı ve koroner bakıma ilk yatışta kaydedilen solunum frekansı değeri,

STAI-Durumluk Anksiyete puanının % 39’unu açıkladı (p<0.0001). STAI-Sürekli Anksiyete puanı ve MMSE puanı, BDI puanındaki değişimin % 37’sini belirledi (p<0.0001).

Tartışma: Akut koroner sendromda, fonksiyonel düzey, eğitim süresi, bilişsel fonksiyon, önceki perkütan uygulamalar ve ilk yatışta kaydedilen solunum frekansı değeri, depresyon ve anksiyete düzeyini belirlemektedir. Kardiyak rehabilitasyon programları planlanırken fiziksel fonksiyonların yanı sıra psikososyal durumunda göz önünde bulundurulmalıdır.

Anahtar Kelimeler

• Akut koroner sendrom,anksiyete,depresyon,bilişsel

DETERMINANTS OF ANXIETY AND DEPRESSION LEVEL IN PATIENTS WITH ACUTE CORONARY SYNDROME

Abstract

Purpose: Anxiety and depression are common health problems affecting course of the cardiac rehabilitation in patients with acute coronary syndrome. The purpose of this study was to investigate the determinants of anxiety and depression in patients with acute coronary

syndrome.

Methods: Fifty patients (42 males, 8 females) hospitalized in coronary care unit with a diagnosis of acute coronary syndrome participated in the study. Physical, physiological and demographic characteristics of the patients were recorded. The Global Registry of Acute

Coronary Events (GRACE) risk score was calculated. Functional level was determined using the New York Heart Association Classification (NYHA). Anxiety was evaluated using the State-Trait Anxiety Inventory (STAI). Depression was determined using the Beck Depression Inventory (BDI). Cognitive function evaluated using the Mini Mental State Examination (MMSE).

Results: According to multiple linear regression analysis, the BDI score and NYHA class explained 45% of the variance in the STAI-Trait Anxiety score (p=0.016). Duration of education, previous percutaneous intervention, and coronary care unit admission respiratory rate explained 39% of STAI-State Anxiety score (p<0.0001). The STAI-Trait Anxiety score and MMSE score explained 37% of the variance in the BDI score (p<0.0001).

Conclusion: Functional level, duration of education, cognitive function, previous percutaneous applications, and admission respiratory rate determine depression and anxiety level in acute coronary syndrome. Psychosocial status as well as physical function should be taken into consideration to plan in to the cardiac rehabilitation programs.

Keywords

• Acute coronary syndromes,anxiety,depression,cognitive

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