Swipe om te navigeren naar een ander artikel
There is growing evidence for the development of posttraumatic stress symptoms as a consequence of acute cardiac events. Acute coronary syndrome (ACS) patients experience a range of acute cardiac symptoms, and these may cluster together in specific patterns. The objectives of this study were to establish distinct symptom clusters in ACS patients, and to investigate whether the experience of different types of symptom clusters are associated with posttraumatic symptom intensity at six months. ACS patients were interviewed in hospital within 48 h of admission, 294 patients provided information on symptoms before hospitalisation, and cluster analysis was used to identify patterns. Posttraumatic stress symptoms were assessed in 156 patients at six months. Three symptom clusters were identified; pain symptoms, diffuse symptoms and symptoms of dyspnea. In multiple regression analyses, adjusting for sociodemographic, clinical and psychological factors, the pain symptoms cluster (β = .153, P = .044) emerged as a significant predictor of posttraumatic symptom severity at six months. A marginally significant association was observed between symptoms of dyspnea and reduced intrusive symptoms at six months (β = −.156, P = .061). Findings suggest acute ACS symptoms occur in distinct clusters, which may have distinctive effects on intensity of subsequent posttraumatic symptoms. Since posttraumatic stress is associated with adverse outcomes, identifying patients at risk based on their symptom experience during ACS may be useful in targeting interventions.
Log in om toegang te krijgen
Met onderstaand(e) abonnement(en) heeft u direct toegang:
Abbas, C. C., Schmid, J. P., Guler, E., Wiedemar, L., Begre, S., Saner, H., et al. (2009). Trajectory of posttraumatic stress disorder caused by myocardial infarction: A two-year follow-up study. International Journal of Psychiatry and Medicine, 39, 359–376. CrossRef
ACC/AHA. (2007). Guidelines for the management of patients with unstable angina/non–ST-elevation myocardial infarction. Journal of the American College of Cardiology, 2007(50), 652–726.
Association, American Psychiatric. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: American Psychiatric Association.
Beck, A. T., & Steer, R. A. (1987). Beck depression inventory manual. Toronto: Ontario: Harcourt, Brace, Jovanovich.
Beutel, M. E., Bleichner, F., von Heymann, F., Tritt, K., & Hardt, J. (2010). Anxiety disorders and comorbidity in psychosomatic in-patients. Psychotherapy and Psychosomatic, 79, 58. CrossRef
Canto, J. G., Shlipak, M. G., Rogers, W. J., Malmgren, J. A., Frederick, P. D., Lambrew, C. T., et al. (2000). Prevalence, clinical characteristics, and mortality among patients with myocardial infarction presenting without chest pain. JAMA: The Journal of the American Medical Association, 283, 3223–3229. CrossRef
Cohen, H., Benjamin, J., Geva, A. B., Matar, M. A., Kaplan, Z., & Kotler, M. (2000). Autonomic dys-regulation in panic disorder and in post-traumatic stress disorder: Application of power spectrum analysis of heart rate variability at rest and in response to recollection of trauma or panic attacks. Psychiatry Research, 96, 1–13. PubMedCrossRef
Dodd, M. J., Miaskowski, C., & Paul, S. M. (2001). Symptom clusters and their effect on the functional status of patients with cancer. Oncology Nursing Forum, 28, 465–470. PubMed
Doerfler, L. A., Paraskos, J. A., & Piniarski, L. (2005). Relationship of quality of life and perceived control with posttraumatic stress disorder symptoms 3 to 6 months after myocardial infarction. Journal of CardiopulmonaryRehabilitation, 25, 166–172.
Eagle, K. A., Lim, M. J., Dabbous, O. H., Pieper, K. S., Goldberg, R. J., Van de Werf, F., et al. (2004). A validated prediction model for all forms of acute coronary syndrome: Estimating the risk of 6-month postdischarge death in an international registry. JAMA: The Journal of the American Medical Association, 291, 2727–2733. CrossRef
Foa, E. B., Cashman, L., Jaycox, L., & Perry, K. (1997). The validation of a self-report measure of posttraumatic stress disorder: The posttraumatic diagnostic scale. Psychological Assessment, 9, 445–451. CrossRef
Foa, E. B., Riggs, D. S., Dancu, C. V., & Rothbaum, B. O. (1993). Reliability and validity of a brief instrument for assessing post-traumatic stress disorder. Journal of Traumatic Stress, 6, 459–472. CrossRef
Gift, A. G., Jablonski, A., Stommel, M., & Given, C. W. (2004). Symptom clusters in elderly patients with lung cancer. Oncololgy Nursing Forum, 31, 202–212.
Goff, D. C., Jr., Sellers, D. E., McGovern, P. G., Meischke, H., Goldberg, R. J., Bittner, V., et al. (1998). Knowledge of heart attack symptoms in a population survey in the United States: The REACT Trial. Rapid Early Action for Coronary Treatment. Archives of Internal Medicine, 158, 2329–2338. PubMedCrossRef
Johnson, J. A., & King, K. B. (1995). Influence of expectations about symptoms on delay in seeking treatment during myocardial infarction. American Journal of Critical Care, 4, 29–35. PubMed
Kim, H. J., McGuire, D. B., Tulman, L., & Barsevick, A. M. (2005). Symptom clusters: Concept analysis and clinical implications for cancer nursing. Cancer Nursing, 28, 270–282. PubMed
Ladwig, K.-H., Baumert, J., Marten-Mittag, B., Kolb, C., Zrenner, B., & Schmitt, C. (2008). Posttraumatic stress symptoms and predicted mortality in patients with implantable cardioverter-defibrillators: Results from the prospective living with an implanted cardioverter-defibrillator study. Archives of General Psychiatry, 65, 1324–1330. PubMedCrossRef
McFarlane, A. C., & Papay, P. (1992). Multiple diagnoses in posttraumatic stress disorder in the victims of a natural disaster. Journal of Nervous and Mental Disorders, 180, 498–504. CrossRef
Mollica, R. F., McInnes, K., Sarajlic, N., Lavelle, J., Sarajlic, I., & Massagli, M. P. (1999). Disability associated with psychiatric comorbidity and health status in Bosnian refugees living in Croatia. JAMA: The Journal of the American Medical Association, 282, 433–439. CrossRef
Pedersen, S. S., & Denollet, J. (2004). Validity of the type D personality construct in Danish post-MI patients and healthy controls. Journal of Psychosom Research, 57, 265–272. CrossRef
Rocha, L. P., Peterson, J. C., Meyers, B., Boutin-Foster, C., Charlson, M. E., Jayasinghe, N., et al. (2008). Incidence of posttraumatic stress disorder (PTSD) after myocardial infarction (MI) and predictors of ptsd symptoms post-MI—A brief report. International Journal of Psychiatry and Medicine, 38, 297–306. CrossRef
Salcioglu, E., Basoglu, M., & Livanou, M. (2003). Long-term psychological outcome for non-treatment-seeking earthquake survivors in Turkey. Journal of Nervous and Mental Disorders, 191, 154–160.
Steptoe, A., Molloy, G. J., Messerli-Bürgy, N., Wikman, A., Randall, G., Perkins-Porras, L. & Kaski, J. C. (2011). Fear of dying and inflammation following acute coronary syndrome. European Heart Journal, 1– 10.
Tabachnick, B. G., & Fidell, L. S. (1996). Using multivariate statistics. New York: HarperCollins.
Thombs, B. D., de Jonge, P., Coyne, J. C., Whooley, M. A., Frasure-Smith, N., Mitchell, A. J., et al. (2008). Depression screening and patient outcomes in cardiovascular care: A systematic review. JAMA: The Journal of the American Medical Association, 300, 2161–2171. CrossRef
Wikman, A., Molloy, G., Randall, G. & Steptoe, A. (2011). Cognitive predictors of posttraumatic stress symptoms. Psychology & Health, 1– 15.
- Symptom experience during acute coronary syndrome and the development of posttraumatic stress symptoms
Gerard J. Molloy
- Springer US