Department of Cardiac Surgery, Ceynowa Specialist Hospital, Dr. Jagalski Str. 10, 84-200, Wejherowo, Poland.
Department of Systems and Computer Networks, Faculty of Information and Communication Technology, Wrocław University of Science and Technology, Wrocław, Poland.
World J Surg. 2022 Aug;46(8):1997-2004. doi: 10.1007/s00268-022-06582-1. Epub 2022 May 13.
Patient-reported outcomes (PROs) which demand special attention and immediate help are referred to as PROs alert. Suicidal ideation (SI) is one of the PROs alerts which are insufficiently investigated. The aim was to assess the prevalence and risk factors for SI in patients following cardiac surgery.
A total of 190 patients (mean age: 66.09, SD = 10.19; 57 women) were assessed at three months following cardiac surgery. SI was identified using the Patient Health Qustionnaire-9 (PHQ-9) question. The Hospital Anxiety and Depression Scale-Modified was used to assess anxiety, depression, and irritability. Additionally, self-perceived health improvement and level of hope were assessed using the Likert scale. Dyspnea and chest pain were assessed using a visual analogue scale.
SI was observed in 14.7% of participants. Patients experiencing SI had significantly higher levels of depression, anxiety, irritability, dyspnea and chest pain. They perceived the surgery to be less effective and had lower levels of hope. No significant relationships were found regarding age, sex, employment status, myocardial infarction, heart failure, operation mode, type of procedure, extracorporal circulation, hospital stay and postsurgical complications. Logistic regression revealed female sex (B = 2.363), higher anxiety level (B = 0.451) and older age (B = 0.062) to be risk factors for SI. The total variance explained by the model was 46%.
Assessing suicidality and negative emotions with special emphasis on anxiety simultaneously with somatic complaints is vital to address PROs alerts and improve care for patients following cardiac surgery. In-depth evaluation and psychological care are recommended in case of positive screening.
需要特别关注和立即帮助的患者报告结局(PROs)被称为 PROs 警报。自杀意念(SI)是 PROs 警报之一,目前对其研究还不够充分。本研究旨在评估心脏手术后患者 SI 的发生率和危险因素。
共 190 名患者(平均年龄:66.09,SD=10.19;57 名女性)在心脏手术后 3 个月接受评估。采用患者健康问卷-9(PHQ-9)问题来识别 SI。采用改良的医院焦虑抑郁量表评估焦虑、抑郁和易怒。此外,采用李克特量表评估自我感知健康改善和希望水平。采用视觉模拟量表评估呼吸困难和胸痛。
14.7%的参与者出现 SI。经历 SI 的患者抑郁、焦虑、易怒、呼吸困难和胸痛程度显著更高。他们认为手术效果较差,希望水平较低。年龄、性别、就业状况、心肌梗死、心力衰竭、手术方式、手术类型、体外循环、住院时间和术后并发症与 SI 无显著相关性。逻辑回归显示,女性(B=2.363)、更高的焦虑水平(B=0.451)和更高的年龄(B=0.062)是 SI 的危险因素。模型解释的总方差为 46%。
评估自杀意念和负性情绪,同时特别关注焦虑和躯体症状,对于处理 PROs 警报和改善心脏手术后患者的护理至关重要。在筛查阳性的情况下,建议进行深入评估和心理护理。