Sexual Satisfaction and Quality of Life in Cardiovascular Patients: The Mediating Role of Anxiety

Q: What are the key findings of this study?

Anxiety partially mediated the association between SF-36 physical health quality of life and sexual satisfaction (indirect effect ab = -0.0191, 95% CI -0.04352 to -0.00003) in cardiac patients.

Q: What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Cardiovascular disease undergoing cardiac rehabilitation (n=128). Intervention: Anxiety and depression symptoms (HADS) and health-related quality of life (SF-36). Primary outcome: Sexual satisfaction disturbance measured by the Sexual Adjustment Scale (SAS), and the indirect mediating effect of anxiety between SF-36 physical health (PCS) and SAS (Indirect effect (ab) -0.0191, 95% CI -0.04352 to -0.00003, p=<0.05).

Q: What does this research mean for the field?

Symptoms of anxiety partially mediate the relationship between physical health-related quality of life and sexual satisfaction in cardiovascular disease patients. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.NEUTRAL.

Q: What question did this study set out to answer?

Investigate the mediating role of anxiety and depression in the relationship between quality of life and sexual satisfaction in patients with cardiovascular disease.

Maria Stella Epifanio; Sabina La Grutta; Pietro Alfano; Salvatore Marcantonio; Marco Andrea Piombo; Martina Ammirata; E Rebulla; Silvia Grassi; Simona Leone; Francesco Clemenza; Rosario Girgenti; Rosa Lo Baido; Maria Di Blasi

doi:10.3390/healthcare11030290

January 18, 2023HealthcareOpen Access

Sexual Satisfaction and Quality of Life in Cardiovascular Patients: The Mediating Role of Anxiety

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Key result

Anxiety partially mediates the link between poorer physical health and reduced sexual satisfaction in cardiac patients.

Indirect effect (ab) -0.0191
95% CI -0.04352 to -0.00003
P<0.05
n=128

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Why the study?

The study was conducted to investigate the mediating role of anxiety and depression in the relationship between quality of life and sexual satisfaction in cardiovascular disease patients.

Do anxiety and depression mediate the relationship between health-related quality of life and sexual satisfaction in hospitalized cardiovascular rehabilitation patients?

Key Points

Investigate the mediating role of anxiety and depression in the relationship between quality of life and sexual satisfaction in patients with cardiovascular disease.
Assessed 128 adult cardiovascular patients (69.5% male, mean diagnosis age 61.92 years) hospitalized in a cardiac rehabilitation center.
Administered the SF-36 health survey, the HADS anxiety and depression scale, and the Sexual Satisfaction Scale (SAS), alongside left ventricular ejection fraction and clinical diagnoses.
Applied mediation models using 5,000 bootstrap samples to determine the indirect and direct effects of physical and mental health dimensions on sexual satisfaction.
Physical health on the SF-36 was negatively correlated with SAS disorder scores (r = -0.247, p = 0.005), anxiety (r = -0.261, p = 0.003), and depression (r = -0.300, p < 0.001).
Anxiety partially mediated the relationship between physical health and sexual satisfaction (indirect effect ab = -0.0191, 95% CI -0.04352 to -0.00003), whereas mental health did not correlate with SAS scores (r = -0.090, p = 0.314).

Study Design

Type

Cross-Sectional (n=128)

Multicenter

No

Structured PICO

Do anxiety and depression mediate the relationship between health-related quality of life and sexual satisfaction in hospitalized cardiovascular rehabilitation patients?

P

Population

128 adult cardiovascular patients (mean age 69.0 years, 30.5% female) hospitalized at a single cardiology rehabilitation center, free of dementia, psychiatric disorders, or oncological diagnosis.

E

Exposure

Assessment of health-related quality of life (SF-36 physical [PCS] and mental [MCS] component summaries) and mediating psychological factors (Hospital Anxiety and Depression Scale [HADS] for anxiety and depression)

O

Outcome

Sexual satisfaction and illness-related sexual disturbance measured by the 6-item Sexual Adjustment Scale (SAS) subscale of the Psychosocial Adjustment Scale (PAIS), evaluated via regression mediation analysispatient reported

Main Result

Effect estimate: Indirect effect (ab) -0.0191 (95% CI -0.04352 to -0.00003)

p-value: p=<0.05

In patients undergoing cardiac rehabilitation, anxiety—but not depression—partially mediates the negative impact of poor physical health on sexual satisfaction, highlighting the need to address anxiety and sexual health during cardiovascular recovery.

Limitations

Relatively small sample size recruited from only a single clinical center
Sample consisted predominantly of older men, limiting generalizability to younger patients and women
Reliance on self-reported questionnaires for sexual behavior, mood symptoms, and medical treatment, which are subject to recall errors and social desirability bias
Inability to adjust for prescribed medications due to small sample size and missing/inaccurate self-reported clinical data
Use of a generic quality of life instrument (SF-36) rather than a cardiovascular disease-specific questionnaire
Cross-sectional mediation design does not allow for causal inferences
Relatively small sample size (n=128) recruited from a single clinical center
Sample predominantly comprised of older men (69.5%)
Self-reported questionnaires for sexual behavior, mood symptoms, and medical treatment may be affected by recall errors, social desirability, and missing/inaccurate data
Inability to examine the impact of prescribed drugs or adjust for treatment confounding
Use of a generic quality of life instrument (SF-36) rather than a CVD-specific questionnaire
Cross-sectional data and mediation modeling do not allow for causal inferences

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Implication

Anxiety screening may warrant consideration in cardiac rehabilitation; leaves open causal effects on sexual satisfaction.

Abstract

BACKGROUND: Cardiovascular diseases represent one of the most important problems for public health. Research indicates that elderly patients consider sexual satisfaction as a fundamental aspect of their quality of life and a better sexual function is related to higher general wellbeing. OBJECTIVE: The main objective of this study was to investigate the mediating role of anxiety and depression in the relationship between quality of life and sexual satisfaction in cardiovascular (CVD) patients. METHODS: The sample comprised 128 adult patients, males and females, hospitalized in a Cardiology Rehabilitation clinical center. To collect data, the following were used: a demographic information sheet, the left ventricular ejection fraction (EF) to evaluate cardiac function, cardiovascular diagnosis type, the HADS scale to evaluate anxiety and depression states, a test for sexual satisfaction evaluation (SAS) and the SF-36 survey to measure quality of life. RESULTS: The results indicated that only SF-36 physical health is indirectly related to SAS through its relationship with anxiety. CONCLUSION: A mediating model was proposed to explore the underlying association between sexual satisfaction and quality of life. We recommend investigating perceived general health and sexuality as clinical indicators for therapeutic decisions and risk evaluation for the management of cardiovascular diseases.

Discussion

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Cite This Study

Epifanio et al. (2023) conducted a cross-sectional in Cardiovascular disease undergoing cardiac rehabilitation (n=128). Anxiety and depression symptoms (HADS) and health-related quality of life (SF-36) was evaluated on Sexual satisfaction disturbance measured by the Sexual Adjustment Scale (SAS), and the indirect mediating effect of anxiety between SF-36 physical health (PCS) and SAS (Indirect effect (ab) -0.0191, 95% CI -0.04352 to -0.00003, p=<0.05). Anxiety partially mediated the association between SF-36 physical health quality of life and sexual satisfaction (indirect effect ab = -0.0191, 95% CI -0.04352 to -0.00003) in cardiac patients.

synapsesocial.com/papers/6a8430d9cc8946f1d8c6c309 https://doi.org/10.3390/healthcare11030290

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Sexual Satisfaction and Quality of Life in Cardiovascular Patients: The Mediating Role of Anxiety

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Sexual Satisfaction and Quality of Life in Cardiovascular Patients: The Mediating Role of Anxiety

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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