Depressive symptoms and outcomes in cardiac rehabilitation patients

Wood, J 2010, Depressive symptoms and outcomes in cardiac rehabilitation patients, Doctor of Philosophy (PhD), Health Sciences, RMIT University.


Document type: Thesis
Collection: Theses

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Title Depressive symptoms and outcomes in cardiac rehabilitation patients
Author(s) Wood, J
Year 2010
Abstract Depression is both a risk factor for the development of cardiovascular conditions and a risk factor for poorer mortality and morbidity outcomes in those with existing cardiovascular disease. Cardiac rehabilitation programs aim to modify cardiovascular risk factors and improve prognosis for cardiac patients, yet little research has investigated the relationship between depression, cardiac rehabilitation participation and outcomes. This study aimed to address this need through conduction of a large-scale investigation of depressive symptoms in cardiac patients and their relationship with physical health indicators and long-term outcomes of morbidity and mortality.

Method: A total of 1625 consecutively enrolled cardiac rehabilitation cases (24.2 % female, mean age = 59.8 yrs) completed the Cardiac Depression Scale (CDS, Hare & Davis, 1993) and provided demographic and physical health information. Follow-up data was obtained at discharge (N = 1042), three (N = 742) and twelve (N = 486) month follow-up. Data linkage was used to obtain morbidity information through the Victorian Admitted Episodes Database and mortality information through the Victorian Death Registry (N =1,402) over a mean follow-up period of 3.7 years.

Results: There was a statistically significant reduction in rates of Moderate/Severe depressive symptoms between admission (39.9%) and discharge (19.4%), which was maintained at three (20.3%) and twelve month follow-up (21.3%). Elevated depressive symptoms at admission were associated with poorer morbidity and mortality outcomes. A significant interaction effect between depressive symptoms, program completion and morbidity was found. Further findings on the relationships between depressive symptoms, patient demographics, program completion, physical outcomes, morbidity and mortality are presented.

Conclusion: A clinically significant proportion of cardiac rehabilitation patients reported moderate/severe levels of depressive symptoms, and these were related to poorer morbidity and mortality outcomes. The potential role of cardiac rehabilitation programs in addressing the treatment of depression through provision of structured exercise is discussed and recommendations regarding further research made.
Degree Doctor of Philosophy (PhD)
Institution RMIT University
School, Department or Centre Health Sciences
Keyword(s) Depression
Cardiovascular Disease
Cardiac Rehabilitation
Morbidity
Mortality
Cardiac Depression Scale (CDS)
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Created: Wed, 20 Apr 2011, 11:52:16 EST by Guy Aron
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