Determinants of depressive symptoms in patients with heart failure based on the hopelessness theory of depression.

IF 2.9 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS European Journal of Cardiovascular Nursing Pub Date : 2024-03-12 DOI:10.1093/eurjcn/zvad062
Yilin Zhang, Danhua Hou, Xiaoyu Dong, Qiuge Zhao, Xiuting Zhang, Xiuzhen Fan
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Abstract

Aims: Depressive symptoms are common in patients with heart failure (HF) and are associated with adverse outcomes in this group. This study examined depressive symptoms and associated determinants in patients with HF based on the hopelessness theory of depression.

Methods and results: In this cross-sectional study, a total of 282 patients with HF were recruited from 3 cardiovascular units of a university hospital. Symptom burden, optimism, maladaptive cognitive emotion regulation strategies (MCERSs), hopelessness, and depressive symptoms were assessed using self-reported questionnaires. A path analysis model was established to evaluate the direct and indirect effects. The prevalence of depressive symptoms was 13.8% in the patients. Symptom burden had the greatest direct effect on depressive symptoms (β = 0.406; P < 0.001), optimism affected depressive symptoms both directly and indirectly with hopelessness as the mediator (direct: β = -0.360; P = 0.001; indirect: β = -0.169; P < 0.001), and MCERSs only had an indirect effect on depressive symptoms with hopelessness as the mediator (β = 0.035; P < 0.001).

Conclusion: In patients with HF, symptom burden, decreased optimism, and hopelessness contribute to depressive symptoms directly. What is more, decreased optimism and MCERS lead to depressive symptoms indirectly via hopelessness. Accordingly, interventions aimed at decreasing symptom burden, enhancing optimism, and reducing the use of MCERSs, while declining hopelessness, may be conducive to relieving depressive symptoms in patients with HF.

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基于抑郁无望理论的心力衰竭患者抑郁症状的决定因素。
目的:抑郁症状在心力衰竭(HF)患者中很常见,并与该群体的不良预后有关。本研究以抑郁的绝望理论为基础,对心力衰竭患者的抑郁症状及相关决定因素进行了研究:在这项横断面研究中,从一家大学医院的 3 个心血管科共招募了 282 名高血压患者。通过自我报告问卷对症状负担、乐观情绪、不良认知情绪调节策略(MCERSs)、绝望情绪和抑郁症状进行了评估。建立了一个路径分析模型来评估直接和间接效应。患者抑郁症状的发生率为 13.8%。症状负担对抑郁症状的直接影响最大(β = 0.406;P < 0.001),乐观情绪对抑郁症状的影响既有直接影响,也有间接影响,无望感是中介(直接影响:β = -0.360;P = 0.001;间接影响:β = -0.169;P < 0.001),MCERSs对抑郁症状的影响仅有间接影响,无望感是中介(β = 0.035;P < 0.001):结论:在高血压患者中,症状负担、乐观度下降和绝望感直接导致抑郁症状。结论:在高血压患者中,症状负担、乐观情绪下降和绝望情绪直接导致抑郁症状,而乐观情绪下降和 MCERS 则通过绝望情绪间接导致抑郁症状。因此,旨在减轻症状负担、增强乐观情绪和减少使用 MCERS,同时降低绝望感的干预措施可能有利于缓解高血压患者的抑郁症状。
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来源期刊
European Journal of Cardiovascular Nursing
European Journal of Cardiovascular Nursing CARDIAC & CARDIOVASCULAR SYSTEMS-NURSING
CiteScore
5.10
自引率
10.30%
发文量
247
审稿时长
6-12 weeks
期刊介绍: The peer-reviewed journal of the European Society of Cardiology’s Council on Cardiovascular Nursing and Allied Professions (CCNAP) covering the broad field of cardiovascular nursing including chronic and acute care, cardiac rehabilitation, primary and secondary prevention, heart failure, acute coronary syndromes, interventional cardiology, cardiac care, and vascular nursing.
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