Anxiety and Depression as Predictors of Quality  of Life in Cardiovascular Patients

Authors

  • Fouzia Naeem Effendi Bahria University Health Sciences
  • Anusha Khattak Aga Khan University
  • Maryam Khan Pakistan Institute of Medical Sciences, Karachi
  • Sania Nisar Bahria University Health Sciences
  • Kashaf Fatima Bahria University Health Sciences
  • Eman Tariq Bahria University Health Sciences

DOI:

https://doi.org/10.36283/PJMD13-3/010

Keywords:

Anxiety, Depression, Cardiovascular Diseases, Quality of Life

Abstract

Background: Research indicates that patients with cardiovascular diseases (CVDs) often experience considerable anxiety, depression, or both following an initial cardiovascular event and tend to experience poorer quality of life (QOL). Thus, this study aimed to investigate if anxiety and depression can serve as predictors of QOL in cardiovascular patients.

Methods: An online cross-sectional survey was conducted from February to September 2022 and included only Karachi residents. Participants were included by non-probability convenience sampling. The Diagnostic and Statistical Manual IV Hospital Anxiety and Depression Scale (DSM-IV HADS) and the WHO Quality of Life Brief (WHOQOL-BREF) questionnaire were self-administered. A total of 400 responses were obtained, of which only 369 fulfilled the inclusion criteria, i.e. patients diagnosed with CVD by a cardiologist, aged ≥18, and those who could communicate in English or Urdu. Descriptive frequencies and multiple regression analyses were performed using multiple regression using SPSS v.25.

Results: Most participants were male with a mean age of 51.6±12.4 years and an average time of 3.82±4.86 years since they were diagnosed. Multiple regression analyses showed that anxiety and depression were significant predictors (p<0.001) for decreased quality of life. There was a moderate correlation in the physical, social, and environmental domains (r = 0.637, 0.651, and 0.635) and a weak association in the social domain with an R-value of 0.483.

Conclusion: The findings suggest that addressing anxiety and depression in patients can significantly enhance their lifespan by improving their QOL. Addressing these concerns could lead to a more comprehensive approach to patient care.

Keywords: Anxiety, Depression, Cardiovascular Diseases, Quality of Life.

Author Biographies

  • Fouzia Naeem Effendi, Bahria University Health Sciences

    Bahria University Health Sciences

  • Anusha Khattak, Aga Khan University

    house officer

  • Maryam Khan, Pakistan Institute of Medical Sciences, Karachi

    house officer

  • Sania Nisar, Bahria University Health Sciences

    house officer

  • Kashaf Fatima, Bahria University Health Sciences

    house officer

  • Eman Tariq, Bahria University Health Sciences

    house officer

References

The top 10 causes of death. Available from: https://www.who.int/news-room/fact-sheets/detail/the-top-10-causes-of-death.

Zubair F, Nawaz SK, Nawaz A, Nangyal H, Amjad N, Khan MS. Prevalence of cardiovascular diseases in Punjab, Pakistan: a cross-sectional study. J Public Health. 2018;26(5):523–529. DOI:10.1007/s10389-018-0898-4

Haraldstad K, Wahl A, Andenæs R, Andersen JR, Andersen MH, Beisland E, et al. A systematic review of quality of life research in medicine and health sciences. Qual Life Res. 2019;28(10):2641–2650. DOI: 10.1007/s11136-019-02214-9

Bohm M, Lilja G, Finnbogadóttir H, Cronberg T, Undén J, Friberg H, et al. Detailed analysis of health-related quality of life after out-of-hospital cardiac arrest. Resuscitation. 2019;135:197–204. DOI: 10.1016/j.resuscitation.2018.10.028

Shibata T, Kawakami S, Noguchi T, Tanaka T, Asaumi Y, Kanaya T, et al. Prevalence, Clinical Features, and Prognosis of Acute Myocardial Infarction Attributable to Coronary Artery Embolism. Circulation. 2015;132(4):241–250. DOI: 10.1161/CIRCULATIONAHA.114.015134

Murphy B, Le Grande M, Alvarenga M, Worcester M, Jackson A. Anxiety and Depression After a Cardiac Event: Prevalence and Predictors. Front Psychol. 2020;10:3010. DOI: 10.3389/fpsyg.2019.03010

Watkins LL, Koch GG, Sherwood A, Blumenthal JA, Davidson JRT, O’Connor C, et al. Association of Anxiety and Depression With All‐Cause Mortality in Individuals With Coronary Heart Disease. J Am Heart Assoc. 2(2):e000068. DOI: 10.1161/JAHA.112.000068

Friedmann E, Thomas SA, Liu F, Morton PG, Chapa D, Gottlieb SS. Relationship of depression, anxiety, and social isolation to chronic heart failure outpatient mortality. Am Heart J. 2006;152(5):940.e1-940.e8. DOI: 10.1016/j.ahj.2006.05.009

Fayers PM, Machin D. Quality of Life: The Assessment, Analysis and Interpretation of Patient-reported Outcomes. John Wiley & Sons; 2013. 579 p.

Nikkheslat N, Zunszain PA, Horowitz MA, Barbosa IG, Parker JA, Myint AM, et al. Insufficient glucocorticoid signaling and elevated inflammation in coronary heart disease patients with comorbid depression. Brain Behav Immun. 2015;48:8–18. DOI: 10.1016/j.bbi.2015.02.002

Hy C, Wn W, Ms D, Ge M, Aj C. Anxiety After Stroke: The Importance of Subtyping. Stroke. 2018;49(3). DOI: 10.1161/STROKEAHA.117.020078

Bahall M. Prevalence and associations of depression among patients with cardiac diseases in a public health institute in Trinidad and Tobago. BMC Psychiatry. 2019;19(1):4.

Raza-Ur-Rahman, Ansari MA, Siddiqui AA, Akunzada WA, Hayder Z, Luhano ML. Correlation of Urdu Version of Hospital Anxiety Depression Scale and Hamilton Depression Rating Scale in quantifying depression among post-myocardial infarction patients. Journal of the Liaquat University of Medical and Health Sciences. 2009; 8(2), 131-135.

Khan MNS, Akhter MS, Ayub M, Alam S, Laghari NU. Translation and validation of quality of life scale, the brief version. J Coll Physicians Surg--Pak. 2003;13(2):98–100.

Schober P, Boer C, Schwarte LA. Correlation Coefficients: Appropriate Use and Interpretation. Anesth Analg. 2018;126(5):1763–1768. DOI: 10.1213/ANE.0000000000002864

Silva PAB, Soares SM, Santos JFG, Silva LB. Cut-off point for WHOQOL-bref as a measure of quality of life of older adults. Rev Saude Publica. 2014;48(3):390–397. DOI: 10.1590/s0034-8910.2014048004912

Weiss M, Michels G, Eberhardt F, Fehske W, Winter S, Baer F, et al. Anxiety, depression and quality of life in acute high risk cardiac disease patients eligible for wearable cardioverter defibrillator: Results from the prospective multicenter CRED-registry. PLOS ONE. 2019;14(3):e0213261. DOI: 10.1371/journal.pone.0213261

Ivanovs R, Kivite A, Ziedonis D, Mintale I, Vrublevska J, Rancans E. Association of depression and anxiety with cardiovascular co-morbidity in a primary care population in Latvia: a cross-sectional study. BMC Public Health. 2018;18(1):328. DOI: 10.1186/s12889-018-5238-7

Kütmeç Yilmaz C, Kara FŞ. The effect of spiritual well-being on adaptation to chronic illness among people with chronic illnesses. Perspect Psychiatr Care. 2021;57(1):318–325. DOI: 10.1111/ppc.12566

O’Neill DP, Kenny EK. Spirituality and chronic illness. Image-- J Nurs Scholarsh. 1998;30(3):275–280. DOI: 10.1111/j.1547-5069.1998.tb01305.x

Blay SL, Marchesoni MSM. Association among physical, psychiatric and socioeconomic conditions and WHOQOL-Bref scores. Cad Saúde Pública. 2011;27(4):677–686. DOI:10.1590/S0102-311X2011000400007

X L, S Y, Y W, B Y, J Z. Effects of a transtheoretical model - based intervention and motivational interviewing on the management of depression in hospitalized patients with coronary heart disease: a randomized controlled trial. BMC Public Health. 2020;20(1). DOI: 10.1186/s12889-020-08568-x

Jaarsma T, Halfens R, Tan F, Abu-Saad HH, Dracup K, Diederiks J. Self-care and quality of life in patients with advanced heart failure: the effect of a supportive educational intervention. Heart Lung J Crit Care. 2000;29(5):319–330. DOI: 10.1067/mhl.2000.108323

Moon MK, Yim J, Jeon MY. The Effect of a Telephone-Based Self-management Program Led by Nurses on Self-care Behavior, Biological Index for Cardiac Function, and Depression in Ambulatory Heart Failure Patients. Asian Nurs Res. 2018;12(4):251–257. DOI: 10.1016/j.anr.2018.10.001

Navidian A, Mobaraki H, Shakiba M. The effect of education through motivational interviewing compared with conventional education on self-care behaviors in heart failure patients with depression. Patient Educ Couns. 2017;100(8):1499–1504. DOI: 10.1016/j.pec.2017.02.023

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Published

2024-08-01

How to Cite

1.
Effendi FN, Khattak A, Khan M, Nisar S, Fatima K, Tariq E. Anxiety and Depression as Predictors of Quality  of Life in Cardiovascular Patients. PJMD [Internet]. 2024 Aug. 1 [cited 2024 Oct. 6];13(3):66-72. Available from: https://ojs.zu.edu.pk/pjmd/article/view/2543

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