Underwood M J, Firmin R K, Jehu D
Department of Cardiothoracic Surgery, Groby Road Hospital, Leicester.
Br Heart J. 1993 May;69(5):382-4. doi: 10.1136/hrt.69.5.382.
To assess anxiety, depression, and social adjustment in patients awaiting coronary artery bypass surgery.
Patient completed questionnaire study.
Regional cardiothoracic centre.
109 questionnaires were sent to patients on the waiting list of two cardiothoracic surgeons. Sixty eight (62%) were returned and 15 (22%) of the respondents were women. There was no difference in the response rates for men (53/84) 63% and women (15/25) 60%.
Anxiety and depression were assessed by the hospital anxiety and depression (HAD) scale. Social functioning was assessed by several nine point rating scales on which patients indicated how their work, family relationships, social activities, private leisure activities, and home management were impaired. Patients also indicated the severity of their cardiac symptoms on a questionnaire based on the New York Heart Association classification for the assessment of the functional state of patients with heart disease.
On the HAD scale 19 (28%) patients scored in the clinically significant range for anxiety. Time spent on the waiting list was positively and significantly related to anxiety (p = 0.05). Thirty two (47%) patients scored in the clinically significant range for depression. Time spent on the waiting list was positively and significantly related to depression (p = 0.005). Positive and significant relations were found between time spent on the waiting list and impairment of work (p = < 0.0001), family relationships (p = < 0.0001), private leisure activities (p = < 0.0001), and social activities (p = 0.004). No correlation was found between any of the above variables and the indicated level of clinical symptoms.
This study documents previously unreported associations between the time patients wait for coronary artery surgery and levels of anxiety, depression, and social functioning. Conclusions regarding the causes of these symptoms cannot be made from this small population of patients but these results do suggest that these associations should be studied further.
评估等待冠状动脉搭桥手术患者的焦虑、抑郁及社会适应情况。
患者完成问卷调查研究。
地区心胸中心。
向两位心胸外科医生等待名单上的患者发送了109份问卷。68份（62%）被退回，其中15名（22%）受访者为女性。男性（53/84，63%）和女性（15/25，60%）的回复率无差异。
采用医院焦虑抑郁量表（HAD）评估焦虑和抑郁情况。通过几个九点评定量表评估社会功能，患者需指出其工作、家庭关系、社交活动、私人休闲活动及家庭管理受到的损害程度。患者还需根据纽约心脏病协会对心脏病患者功能状态评估的分类，在问卷上指出其心脏症状的严重程度。
在HAD量表上，19名（28%）患者的焦虑得分处于临床显著范围。等待名单上的时间与焦虑呈正相关且具有统计学意义（p = 0.05）。32名（47%）患者的抑郁得分处于临床显著范围。等待名单上的时间与抑郁呈正相关且具有统计学意义（p = 0.005）。等待名单上的时间与工作损害（p = < 0.0001）、家庭关系损害（p = < 0.0001）、私人休闲活动损害（p = < 0.0001）及社交活动损害（p = 0.004）之间存在正相关且具有统计学意义。上述任何变量与所指出的临床症状水平之间均未发现相关性。
本研究记录了此前未报告的患者等待冠状动脉手术的时间与焦虑、抑郁及社会功能水平之间的关联。虽然无法从这一小部分患者得出这些症状原因的结论，但这些结果确实表明应进一步研究这些关联。
