Anxiety, depression impacts heart-surgery patients ability to self-manage care

A research team from Daphne Cockwell School of Nursing, in Toronto, Canada, reviewed 16 studies to better understand the effect elevated levels of anxiety and depression have on a patient’s ability to care for him/herself the critical first month following heart surgery. When discharged from the hospital, patients are provided important information on ways to prevent infection or complications, including a medication and nutritional regimen.

At least half of the nearly 4,000 patients across the 16 studies reported moderate to severe levels of anxiety and depression during their recovery. Of those patients with elevated levels of distress, the researchers found that they were only able to manage one task at a specific point in time, compared to those with milder anxiety and depression who were able to complete a variety of the self-care tasks.

“From our review of these studies, there is some evidence to suggest that patients with milder anxiety and depression can engage in more self-care management tasks,” says [Dr. Suzanne Fredericks, a professor at Ryerson’s Daphne Cockwell School of Nursing and lead investigator of the study]. “Their ability to perform these tasks can also be linked to their ability to retain and recall knowledge, which would affect how well they can remember the self-care tasks they were taught prior to their hospital discharge.”

Based on their findings, the authors suggest routinely assessing patients for depression and anxiety, and managing their conditions as necessary to improve the efficacy of educating patients on self-care after heart surgery and lower the risk of re-admission to the hospital.

The study, “Anxiety, Depression, and Self-Management: A Systematic Review,” appeared in the November issue of Clinical Nursing Research.

This study is in line with other research that shows that therapy and pharmacological treatment of depression for patients with cardiovascular disease result in improved quality of life and psychosocial functioning, and in reduced medical costs and cardiac morbidity and mortality. Even modest interventions can make a significant difference.

With funding from the National Institutes of Health, Polaris developed Polaris-CV, a computer-based system, normed on the cardiac patient population, that helps health care providers detect, monitor and manage depression and anxiety in patients with heart disease.