Chronic and Complex Care, Faculty of Nursing, Midwifery and Health, University of Technology, Sydney, Australia.
J Adv Nurs. 2009 Nov;65(11):2386-96. doi: 10.1111/j.1365-2648.2009.05101.x. Epub 2009 Sep 11.
Anxiety, depression and perceived control in patients having coronary artery bypass grafts.
This paper is a report of a study to determine (1) the course of anxiety, depression and perceptions of control, and (2) the influence of perceptions of control, in patients undergoing coronary artery bypass grafts before surgery, after surgery in hospital and 2 weeks after discharge.
Anxiety and depression are common in patients undergoing coronary artery bypass graft surgery patients and predictive of worse outcomes. Few researchers have examined the influence of perceived control on these emotional states in the acute surgical period.
A prospective, descriptive design was used with a convenience sample of patients having coronary grafts (n = 155). Anxiety and depression were measured by the Hospital Anxiety and Depression Scale and perceptions of control over their cardiac illness by the Control Attitudes Scale before surgery, after surgery during hospitalization and 2 weeks after hospital discharge. The data were collected in 2005.
Patients had low levels of anxiety at each timepoint; however, borderline or clinically significant levels were common before surgery (38.7%) and after discharge. (38.6%). Depression levels were low, but increased over time (F = 27.03, P < 0.001). Patients had low to moderate perceptions of control over their illness before surgery, which increased over time (F = 25.51, P < 0.001). Those with stronger perceptions of control were less anxious or depressed at all times and those who were more anxious or depressed before surgery continued to be so afterwards.
Routine assessment of anxiety, depression and perceptions of control are justified to identify patients at risk and to intervene to promote control perceptions.
冠状动脉旁路移植术患者的焦虑、抑郁和感知控制。
本研究旨在确定:(1)手术前、住院期间手术后和出院后 2 周内,焦虑、抑郁和控制感的变化情况;(2)控制感对冠状动脉旁路移植术患者的影响。
焦虑和抑郁在接受冠状动脉旁路移植术的患者中很常见,且与预后不良相关。很少有研究人员在急性手术期研究控制感对这些情绪状态的影响。
采用前瞻性描述性设计,对 155 例接受冠状动脉搭桥术的患者进行便利抽样。在手术前、住院期间手术后和出院后 2 周,使用医院焦虑抑郁量表(HADS)和控制态度量表(CAS)测量焦虑和抑郁以及对心脏病的控制感。数据收集于 2005 年。
患者在每个时间点的焦虑水平均较低;但手术前(38.7%)和出院后(38.6%)有接近或达到临床显著水平。抑郁水平较低,但随时间推移而增加(F = 27.03,P < 0.001)。患者在手术前对疾病的控制感较低,但随时间推移而增加(F = 25.51,P < 0.001)。控制感较强的患者在各个时间点焦虑或抑郁程度较低,手术前焦虑或抑郁程度较高的患者在手术后仍保持这种状态。
常规评估焦虑、抑郁和控制感可以识别处于危险中的患者,并进行干预以促进控制感。