The Investigation On Coping Style, Anxiety And Depression In Hospitalized Patients With Coronary Heart Disease

During the occurrence and development of disease, hospitalized patients withcoronary heart disease (CHD) due to various factors can create bad emotions such asanxiety depression and others, which seriously impacts on the treatment and prognosisof disease, and then influences their quality of life. At present, physicians not onlyhave no clear awareness and diagnosis on anxiety and depression, but also give notenough attentions on the mental health status of CHD patients. As a result, somaticsymptoms of anxiety and depression often are diagnosed as physical diseases, leadingto difficulties in diagnosis and treatment. This study is to investigate the coping style,anxiety, depression, and their influencing factors among hospitalized patients withCHD. Also, this study can guide to build positive coping style for patients, contributeto reduce the sufferings and financial burden of patients, provide references onestablishing the policy of psychological nursing intervention, and have a positiveguidance function in prevention, treatment and prognosis of cardiovascular disease.Objectives: To investigate the coping style, anxiety, and depression ofhospitalized patients with CHD, to explore characteristics of their distributions andtheir influencing factors, to search for the improvement direction of diagnosis andtreatment process and nursing service mode for patients, and to provide references onimprovement of patients’ quality of life and psychological education for patients.Methods: In this study, the hospitalized patients with CHD were recruited fromthe Department of Cardiology, general hospital of Daqing oil-field at the period ofOctober2012–April2013. The self-designed questionnaire was used to obtain therelevant information including the general clinical information, coping style, anxiety,depression and others. EPIDATA software was used to enter data, and SPSS softwarewas used to analyze different copying style of hospitalized patients with CHD andinfluencing factors by variance analysis and T-test. The factors influencing anxietyand depression of patients were analyzed by Logistic regression model.Results:(a) There was no statistically significant difference between “face”coping style of hospitalized patients with CHD and the norm (t=0.94, P=0.35), andthe score of coping styles including “avoidance” and “yield” were higher than thenorm (t=16.20, P<0.001; t=23.98, P<0.001). The scores of “face” coping style amongpatients existed significant difference in education, monthly average income per family and payment mode of medical expenses (P<0.05), and CHD patients with loweducation, low income and expenses paid by government had low scores for “face”.The scores of “avoidance” coping style among patients existed significant differencein monthly average income per family, marital status and payment mode of medicalexpenses (P<0.05), and CHD patients with middle income, married and expenses paidby self had high scores for “avoidance”. The scores of “yield” coping style amongpatients existed significant difference in gender and marital status (P<0.05), and maleCHD patients and other marital status including unmarried, divorced or separated, andwidowed tended to “yield”.(b) Among521hospitalized patients with CHD, thepositive rate of anxiety was67.9%,68.2%for male and67.5%for female, and therewas no statistical significance in genders (χ~2=0.032, P=0.858). Diabetes was a riskfactor of CHD patients with anxiety (OR=1.956,95%CI:1.105~3.463).(c) Among521hospitalized patients with CHD, the positive rate of depression was81.4%,80.5%for male and82.8%for female, and there was no statistical significance in genders(χ~2=0.416, P=0.519). Higher level of monthly average income per family was a riskfactor of CHD patients with depression. The monthly average income per family lessthan1500yuan as the baseline, and OR and95%CI of between1500yuan and2999yuan and over3000yuan were2.095(1.105~3.463) and2.684(1.448~4.974)respectively.Conclusion:(a) Most of the hospitalized patients with CHD have “avoidance”and “yield” style, but the male patients and patients with bad marital status have apoor coping style, which should be given attention and social support.(b) The positiverate of anxiety is higher in hospitalized patients with CHD, and diabetes is a riskfactor of CHD patients with anxiety.(c) The positive rate of depression is also higherin hospitalized patients with CHD, and higher level of monthly average income perfamily is a risk factor of CHD patients with depression.(d) Pay attention to the copingstyle, anxiety, and depression of hospitalized patients with CHD, and actively takepsychological counseling and psychological intervention, which could make patientsface the disease in a way of more positive coping styles, and improve the mentalhealth level and quality of life of hospitalized patients with CHD.