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Titre : | Depressive Symptoms and Perceptions of ED Care in Patients Evaluated for Acute Coronary Syndrome (2018) |
Auteurs : | Tara St. Onge ; Donald Edmondson ; Syed Husain ; et al. |
Type de document : | Article |
Dans : | Journal of Emergency Nursing (Vol. 44, n°1, January 2018) |
Article en page(s) : | p. 46-51 |
Langues: | Anglais |
Descripteurs : |
HE Vinci Dépression ; Signes et symptômes ; Soins d'urgence ; Syndrome coronarien aigu |
Mots-clés: | Troubles de stress post-traumatique ; Unité hospitalière d'urgences |
Résumé : |
Introduction
Posttraumatic stress disorder (PTSD) develops in 1 out of 8 survivors of acute coronary syndrome (ACS) events, and these persons have a doubling of risk for recurrent ACS and mortality. Overcrowding in the emergency department during ACS evaluation has been associated with increased risk for PTSD, and depressed patients have been found to be particularly vulnerable. Little is known about the mechanisms by which overcrowding increases PTSD risk in depressed patients. Our aim was to evaluate one possible mechanism, patient perception of crowding and care, in depressed and nondepressed ED patients evaluated for ACS. Methods We enrolled 912 participants in the REactions to Acute Care and Hospitalization study, an ongoing observational cohort study assessing patients evaluated for ACS. Participants completed the Emergency Department Perceptions questionnaire. Depressive symptoms were screened using the Personal Health Questionnaire Depression Scale. Objective ED crowding was calculated using the Emergency Department Work Index (EDWIN). Results EDWIN scores did not significantly differ between groups. Although perceptions of ED crowding did not differ between groups, depressed patients perceived the emergency department as more stressful [t = 4.45, P Discussion We found that depressed patients experienced the emergency department as more stressful as objectively measured crowding increased. Our study highlights the complex interplay between cardiovascular disease and mental health in impacting patient health outcomes in the emergency department. Image 1 Contribution to Emergency Nursing Practice Post-traumatic stress disorder symptoms develop in an estimated 1 in 8 survivors of acute coronary syndrome (ACS) events. Such negative psychological outcomes in these cardiac patients in turn have been associated with increased cardiac morbidity and mortality. Overcrowding in the emergency department has been associated with increased risk of the development of post-traumatic stress disorder, and depressed patients in particular appear vulnerable. This study found that currently depressed patients evaluated for ACS had significantly worse perceptions of ED care and stress during ED evaluation. Results from this study highlight the importance of emergency nurse providers in assessing both cardiovascular and psychological well-being when evaluating patients for potential ACS events. |
Disponible en ligne : | Non |