Michalski Piotr, Kosobucka-Ozdoba Agata, Pietrzykowski Łukasz, Kasprzak Michał, Grzelakowska Klaudyna, Rzepka-Cholasińska Alicja, Kubica Aldona
Department of Cardiac Rehabilitation and Health Promotion, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Marii Sklodowskiej-Curie St. 9, 85-094 Bydgoszcz, Poland.
Department of Cardiology and Internal Medicine, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Marii Sklodowskiej-Curie St. 9, 85-094 Bydgoszcz, Poland.
Nurs Rep. 2024 Sep 23;14(3):2596-2604. doi: 10.3390/nursrep14030191.
A chronic disease occurring in a person's life is a stressor, disrupting every aspect of their life.
This study aims to assess the relationship between functioning in chronic illness and quality of life with the prevalence of symptoms of depression and anxiety in patients with high cardiovascular risk.
This study included 200 patients (aged 18-80 years) under the care of a primary care physician, diagnosed with hypertension and/or hypercholesterolemia, and/or diabetes between 6 and 24 months before the enrollment. The presented analysis assessed the symptoms of anxiety and depression using the Hospital Anxiety and Depression Scale (HADS); and the quality of life of patients with cardiovascular disease using the Heart Quality of Life (HeartQoL) questionnaire and functioning in chronic illness using the Functioning in Chronic Illness Scale (FCIS).
The HADS scores amounted to 4.34 ± 3.414 points for the HADS-Anxiety subscale and 3.20 ± 2.979 points for the HADS-Depression subscale. The score indicative of functioning in chronic illness assessed with the FCIS was 98.32 ± 13.89 points. The independent predictors of HADS-anxiety were HeartQoL Emotional and FCIS Global, while HeartQoL Global and FCIS Global were the independent predictors for HADS-depression. Better functioning in chronic illness (FCIS Global) was associated with less frequent symptoms of anxiety and depression based on the HADS: HADS-Anxiety (R Spearmann = -0.3969; < 0.0001) and HADS-Depression (R Spearmann = -0.5884; < 0.0001). Higher HeartQoL scores, both globally, as well as in emotional and physical dimensions, were associated with a lower severity of anxiety and depression assessed with the HADS: HADS-Anxiety (R Spearmann = -0.2909; = 0.0001) and HADS-Depression (R Spearmann = -0.2583; = 0.0002).
The quality of life and functioning in chronic illness are connected with symptoms of depression and anxiety. When assessing the severity of the depression symptoms in relation to the individual aspects of functioning in chronic illness, the areas requiring supportive-educational intervention can be identified. The assessment of both functioning in a chronic disease and the severity of the depression symptoms should be included in a standard nursing diagnosis and further supportive and educational intervention.
慢性病出现在一个人的生活中是一种压力源，会扰乱他们生活的方方面面。
本研究旨在评估心血管疾病高风险患者慢性病功能与生活质量之间的关系以及抑郁和焦虑症状的患病率。
本研究纳入了200名（年龄在18 - 80岁之间）在初级保健医生照料下的患者，这些患者在入组前6至24个月被诊断患有高血压和/或高胆固醇血症和/或糖尿病。本分析使用医院焦虑抑郁量表（HADS）评估焦虑和抑郁症状；使用心血管疾病生活质量（HeartQoL）问卷评估心血管疾病患者的生活质量，并使用慢性病功能量表（FCIS）评估慢性病功能。
HADS焦虑分量表得分4.34 ± 3.414分，HADS抑郁分量表得分3.20 ± 2.979分。用FCIS评估的慢性病功能得分是98.32 ± 13.89分。HADS焦虑的独立预测因素是HeartQoL情绪维度和FCIS总体维度，而HeartQoL总体维度和FCIS总体维度是HADS抑郁的独立预测因素。基于HADS，慢性病功能更好（FCIS总体维度）与焦虑和抑郁症状出现频率较低相关：HADS焦虑（斯皮尔曼相关系数R = -0.3969；P < 0.0001）和HADS抑郁（斯皮尔曼相关系数R = -0.5884；P < 0.0001）。HeartQoL得分越高，无论是总体得分，还是情绪和身体维度得分，与用HADS评估的焦虑和抑郁严重程度越低相关：HADS焦虑（斯皮尔曼相关系数R = -0.2909；P = 0.0001）和HADS抑郁（斯皮尔曼相关系数R = -0.2583；P = 0.0002）。
慢性病中的生活质量和功能与抑郁和焦虑症状相关。在评估与慢性病功能的各个方面相关的抑郁症状严重程度时，可以确定需要支持性教育干预的领域。慢性病功能评估和抑郁症状严重程度评估都应纳入标准护理诊断以及进一步的支持性和教育性干预。
