Predictors of psychological distress in patients at home following cardiac surgery: an explorative panel study

BACKGROUND: Knowledge is lacking on what predicts psychological distress in cardiac surgery patients. AIM: To describe the post-operative symptoms of anxiety and depression in cardiac surgery patients; to detect associations between those symptoms and patient's experiences of illness and hospitalisation and also their family and social situations; and identify experiences and situations that predict symptoms of anxiety and depression at home when measured at least four weeks after hospital discharge. METHOD: In this prospective explorative panel study all eligible cardiac surgery patients over a six month period in 2007 were invited to participate. Data was collected at the hospital and at home. Two questionnaires were developed and included the hospital anxiety and depression scale (HADS), questions on family and social issues, patient's experience of illness, hospitalisation and family and social situations. RESULTS: Of the 66 participants few had symptoms of anxiety and depression at hospital or at home. Significant associations were found between symptoms of anxiety and depression measured at home and the same symptoms at hospital; pain and general post-operative symptoms; satisfaction with discharge education; self-assessed post-operative recovery and quality of sleep at home. Post-operative anxiety was predicted by depression at the hospital, not feeling rested upon awakening and presence of pain at home. Post-operative depression was predicted by depression at the hospital and not feeling rested upon awakening. CONCLUSION: Signs of patients' anxiety and depression should be assessed before surgery and appropriate intervention planned accordingly in order to support patients at risk of post-operative psychological distress.