Anxiety and depression in cardiac surgery: sex and age range differences
La ansiedad y la depresión en la cirugía cardíaca: diferencias entre género y edad
Ansiedade e depressão em cirurgia cardíaca: diferenças entre sexo e faixa etária
Hélen Francine Rodrigues; Rejane Kiyomi Furuya; Rosana Aparecida Spadoti Dantas; Carina Aparecida Marosti Dessotte
Abstract
Objective: To investigate the association between anxiety and depression symptoms and sex and age among preoperative patients submitted to their first cardiac surgery.
Methods: This is a correlational cross-sectional study, with 84 participants. The Hospital Anxiety and Depression Scale was used. Student's t-test for independent samples (sex), ANOVA (age group), and linear regression analysis were used, with a significance level of 5%.
Results: Women had more anxiety and depression symptoms, with higher mean values and statistically significant differences (p = 0.007 and p = 0.001). In the regression analysis, sex was significant in the model (p = 0.011). Considering age, the differences regarding the presence of these symptoms were not statistically significant, either in ANOVA or in the regression analysis.
Conclusion: Women had more anxiety and depression symptoms in the preoperative period of cardiac surgeries. Nurses should consider these results during the educational plan preparation for surgical patients.
Keywords
Resumen
Palabras clave
Resumo
Objetivo: Verificar a relação dos sintomas de ansiedade e depressão com o sexo e a idade de pacientes em pré-operatório de primeira cirurgia cardíaca.
Métodos: Estudo correlacional, transversal, com 84 participantes. Utilizada a Escala Hospitalar de Ansiedade e Depressão. Realizado o teste t de Student para amostras independentes (sexo), ANOVA (idade agrupada) e análises de regressões lineares, com nível de significância de 5%.
Resultados: As mulheres apresentaram mais sintomas de ansiedade e de depressão, com maiores médias e diferenças estatisticamente significantes (p = 0,007 e p = 0,001). Na análise de regressão, o sexo foi significativo no modelo (p = 0,011). Considerando-se a idade, as diferenças encontradas em relação à presença desses sintomas não foram estatisticamente significantes, tanto na ANOVA quanto na regressão.
Conclusão: As mulheres apresentaram mais sintomas de ansiedade e de depressão no pré-operatório de cirurgias cardíacas. Esses dados devem ser considerados pelos enfermeiros ao elaborarem os planos de educação do paciente cirúrgico.
Palavras-chave
Referencias
1 World Health Organization (WHO). Global Atlas on Cardiovascular Disease Prevention and Control. Mendis S, Puska P, Norrving B editors. Geneva: World Health Organization; 2011. Available from:
2 Fathi M, Alavi SM, Joudi M, Joudi M, Mahdikhani H, Ferasatkish R, et al. Preoperative anxiety in candidates for heart surgery. Iran J Psychiatry Behav Sci [on line]. 2014 summer; [cited 2015 ago 10];8(2): [about 6 screens]. Available from:
3 Guo P. Preoperative education interventions to reduce anxiety and improve recovery among cardiac surgery patients: a review of randomised controlled trials. J Clin Nurs [on line]. 2015 jan; [cited 2015 ago 12];24(1-2): [about 12 screens]. Available from:
4 Szczepanska-Gieracha J, Morka J, Kowalska J, Kustrzycki W, Rymaszewska J. The role of depressive and anxiety symptoms in the evaluation of cardiac rehabilitation efficacy after coronary artery bypass grafting surgery. Eur J Cardiothorac Surg [on line]. 2012 nov; [cited 2015 ago 05];42(5): [about 6 screens]. Available from:
5 Poole L, Leigh E, Kidd T, Ronaldson A, Jahangiri M, Steptoe A. The combined association of depression and socioeconomic status with length of post-operative hospital stay following coronary artery bypass graft surgery: data from a prospective cohort study. J Psychosom Res [on line]. 2014 jan; [cited 2015 ago 9];76(1): [about 6 screens]. Available from:
6 Modica M, Ferratini M, Spezzaferri R, De Maria R, Previtali E, Castiglioni P. Gender differences in illness behavior after cardiac surgery. J Cardiopulm Rehabil Prev [on line]. 2014 mar/apr; [cited 2015 ago 5];34(2): [about 6 screens]. Available from:
7 Williams JB, Alexander KP, Morin JF, Langlois Y, Noiseux N, Perrault LP, et al. Preoperative anxiety as a predictor of mortality and major morbidity in patients aged >70 years undergoing cardiac surgery. Am J Cardiol [on line]. 2013 jan 01; [cited 2015 may 5];111(1): [about 5 screens]. Available from:
8 Folstein MF, Folstein SE, McHugh PR. "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res [on line]. 1975 nov; [cited 2015 jan 5];12(3): [about 8 screens]. Available from:
9 Brucki S, Nitrini R, Caramelli P, Bertolucci PHF, Okamoto IH. Suggestions for utilization of the mini-mental state examination in Brazil. Arq Neuropsiquiatr [on line]. 2003; [cited 2015 may 5];61(3B): [about 4 screens]. Available from:
10 Dessotte CAM, Silva FS, Furuya RK, Ciol MA, Hoffman JM, Dantas RAS. Somatic and cognitive-affective depressive symptoms among patients with heart disease: differences by sex and age. Rev Lat Am Enfermagem [on line]. 2015 feb/apr; [cited 2015 dec 9];23(2): [about 8 screens]. Available from:
11 Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand [on line]. 1983 jun; [cited 2015 jun 5];67(6): [about 8 screens]. Available from:
12 Botega NJ, Bio MR, Zomignani MA, Garcia Jr C, Pereira WAB. Mood disorders among medical in-patients: a validation study of the hospital anxiety and depression scale (HAD). Rev Saude Publica [on line]. 1995; [cited 2015 jun 5];29(5): [about 4 screens]. Available from:
13 Navarro-García MA, Marín-Fernández B, Carlos-Alegre V, Martínez-Oroz A, Martorell-Gurucharri A, Ordoñez-Ortigosa E, et al. Preoperative mood disorders in patients undergoing cardiac surgery: risk factors and postoperative morbidity in the intensive care unit. Rev Esp Cardiol [on line]. 2011 nov; [cited 2015 jun 5];64(11): [about 5 screens]. Available from:
14 Sveinsdóttir H, Ingadóttir B. Predictors of psychological distress in patients at home following cardiac surgery: an explorative panel study. Eur J Cardiovasc Nurs [on line]. 2012 sep; [cited 2015 jul 5];11(3): [about 8 screens]. Available from:
15 Khan RS, Skapinakis P, Ahmed K, Stefanou DC, Ashrafian H, Darzi A, et al. The association between preoperative pain catastrophizing and postoperative pain intensity in cardiac surgery patients. Pain Med [on line]. 2012 jun; [cited 2015 jul 5];13(6): [about 6 screens]. Available from:
16 Pinton FA, Carvalho CF, Miyazaki MCOS, Godoy MF. Depression as a risk factor for early and late morbidity after coronary artery bypass surgery. Rev Bras Cir Cardiovasc [on line]. 2006 jan/mar; [cited 2015 dec 9]; 21(1): [about 7 screens]. Available from:
17 Mitchell RH, Robertson E, Harvey PJ, Nolan R, Rodin G, Romans S, et al. Sex differences in depression after coronary artery bypass graft surgery. Am Heart J [on line]. 2005 nov; [cited 2015 dec 10];150(5): [about 9 screens]. Available from:
18 Shanmugasegaram S, Russell KL, Kovacs AH, Stewart DE, Grace SL. Gender and sex differences in prevalence of major depression in coronary artery disease patients: a meta-analysis. Maturitas [on line]. 2012 dec; [cited 2015 ago 11];73(4): [about 5 screens]. Available from:
19 Sutherland AM, Katznelson R, Clarke HA, Tait G, Beattie WS. Use of preoperative antidepressants is not associated with postoperative hospital length of stay. Can J Anaesth [on line]. 2014 jan; [cited 2015 dec 9];61(1): [about 5 screens]. Available from:
20 Krannich JHA, Weyers P, Lueger S, Herzog M, Bohrer T, Elert O. Presence of depression and anxiety before and after coronary artery bypass graft surgery and their relationship to age. BMC Psychiatry [on line]. 2007 sep 12; [cited 2015 dec 10];47(7): [about 6 screens]. Available from:
21 Huffman JC, Celano CM, Beach SR, Motiwala SR, Januzzi JL. Depression and Cardiac Disease: Epidemiology, Mechanisms, and Diagnosis. Cardiovasc Psychiatry Neurol [on line]. 2013 jan; [cited 2015 ago 13 ];2013: [about 13 screens]. Available from:
22 Tully PJ, Newland RF, Baker RA. Cardiovascular risk profile before coronary artery bypass graft surgery in relation to depression and anxiety disorders: An age and sex propensity matched study. Aust Crit Care [on line]. 2015 feb; [cited 2015 may 8];28(1): [about 5 screens]. Avaible from:
Submitted date:
20/10/2015
Accepted date:
05/05/2016