The Effect of Partnership Care Model on Depression and Anxiety in the Patients with Heart Failure

Document Type: Original Quantitative and Qualitative Research Paper

Authors

1 MSc in Nursin, Nursing and Midwifery School, Kerman University of Medical Sciences, Kerman, Iran

2 Faculty Member of Nursing and Midwifery School, Kerman University of Medical Sciences, Kerman, Iran

3 Associate Professor, Tarbiat Modares Univesity, Tehran, Iran

4 BSc in Nursin, Nursing and Midwifery School, Kerman University of Medical Sciences, Kerman, Iran

Abstract

Background: Depression and anxiety are highly prevalent in heart failure patients and has been associated with adverse prognosis, reduced functional ability and greater use of health care resources.
Aim: To determine the effect of using partnership care model on anxiety and depression in heart failure patients.
Method: This clinical trial was conducted as quasi-experimental design on 90 patients with heart failure in two educational hospitals in Kerman/Iran in 2010 – 2011. The patients were divided equally and randomly allocated to experimental and control groups. The partnership care model which consisted of 4 main steps of orientation, sensitization, performing and evaluation was performed for experimental group. The level of anxiety and depression of both groups were measured using Beck Depression Inventory and Beck Anxiety Inventory. Data were analyzed by SPSS software (Version 18) using paired t test, one way ANONA, and Chi-square test.
Results: The mean score of anxiety in control and experimental groups was 32.73±10.23 and 33.45±11.83 before the intervention, respectively.  The scores after the intervention were 35.32±10.10 (in control group) and 13.96±5.05 (in experimental group) (P=0.000). The mean score of depression before running the intervention was 24.73±8.21 in the control group and 26.97±10.40 in the experimental group, which reduced after the intervention to 29.14±8.62 in control group and 13.26±4.25 in experimental group (P=0.000).
Conclusion: Applying partnership care model can reduce level of anxiety and depression in heart failure patients. Therefore, it is recommended to use this model to control and reduce anxiety and depression in heart failure patients.

Keywords


  1. Stewart S, Macintyre K, Cape well S, Mcmurray JJ .Heart failure and aging population: an increasing burden in the 21st century? Heart 2003;89:49-53.
  2. Diskstain K ,Cohen-Solae A, Filippatos G, Mcmurray JJ, Ponikowski P, Noole- Wilson PA, et al. ESC guidelines for diagnosis and treatment of acute heart failure 2008:the task force fore the diagnosis and treatment of acute and chronic heart failure 2008 of the uropean society of cardiology. Eur J Heart Fail 2008; 10:933-989.
  3.  American Heart Association. Heart disease and stroke statistics-2005 update. Dallas (TX): American heart association; 2005.
  4. Cully J, Jimenez DE, Ledoux TA, Deswal A. Recognition and treatment of depression and anxiety symptoms in heart failure. Prim care companion J clin psychiatry 2009; 11(3):103-9.
  5. Jiang W, Alexander J, Christopher E, et al. Relationship of depression to increase risk of mortality and rehospitalization in patients with heart failure. Arch Intern Med 2001; 161:1849-56.
  6. Rutledge T, Reis VA, Linked SE, et al. Depression in heart failure: a meta-analytic review of prevalence, intervention effects, and associations with clinical outcomes. J Am coll Cardiol 2006; 48:1527-37.
  7. Konstam V, Moser BK, De Jong MJ.Depression and anxiety in heart failure, cardiac failure 2005; 11(6):455-63.
  8. Beck AT .Depression: causes and treatments.Philadeiphia (PA): University of Pennsylvania press 1967.
  9. Reigel B ,Lee CS ,Dickson VV ,Carlson B .an update on self care of heart failure index .J Cardiovascular Nurs 2009 ;24:485.
  10. Muberg TA, Bru E, Svebak S, Tveteras R .Depressed mood and subjective health symptoms as predictors of mortality in patients with conjestive heart failure: a two-years follow- up stydy.Int J Psychiatry Med 1999;29:311-26.
  11. Vaccarino V, Kasal SV, Abramson J, Krumholmz HM. Depressive symptoms and risk of functional decline and death in patients with heart failure. J Am coll Cardiol 2001; 38:199-205.
  12. Faris R, Purcell H, Henein MY, Coats AJ.clinical depression is common and significantly associated with reduced survival in patients with non-ischemic heart failure. Eur J Heart fail 2002; 4:541-51.
  13. Conwell Y. suicide in elderly patients patients.in: schnieder LS, Reynolds CT, lebowitz BD, eds. diagnosis and treatment of depression in late life. washington DC: American psychiatric press,inc;1996:397-418.
  14. De jong MJ, Moser DK, An K, Chung ML. Anxiety is not manifested by elevated heart rate and blood pressure in actually ill cardiac patients. Eur cardiovasc Nurs 2004; 3:247-53.
  15. Moser DK,Dracup K, Doering L, Evangelista L, Zambroski CH, et al. Depression, anxiety, host, Pasternak RC, Desanctic RW. The influence of anxiety and depression on outcomes of patients with coronary artery disease. Arch Intern Med 2000; 160:1913-21.
  16. Freedland KE ,Walden J ,Stevenson L ,et al. depression in elderly with conjestive heart failure .J Geriatr psychiatry.1999;24(1):59-71.
  17. Mohammadi E. Design and Evaluation of Partnership Care Model for High Blood Pressure. Thesis PHD, Nursing) Tehran Tarbeiat Modares University: 2002. (Persian)
  18. Azadi F, Mohammadi E.Effect of using partenership care model on quality of life in coronary artery disease patients. Iran J Nurs Res 2006; 1(2):23-9.
  19. Groth-Marnat G. [Handbook of psychological assessment]. Pasha Sharifi H. (translator). 2nd ed. Tehran: Roshd; 1996: 225-6. (Persian)
  20. Kaviani H, Sadat Moosavi A, Mohit A. [Interview and psychological test]. 1st ed. Tehran: Sana; 2001: 169. (Persian)
  21. Khoshnevis M, Javadinasab M, Ghanei M, Hoseini Y, Karimi Zarchi AK, Ebadi A,Babatabari H. Effect of using collaborative model of care on quality of life of chemical injuries with chronic bronchiolitis.Iran J Crit Care Nurs 2009; 2(2): 47-50. (Persian)
  22. Oxman TE, Hull JG. Social support, depression, and activities of daily living in older heart surgery patients. J Gerontol B Psychol Sci Soc Sci 1997; 52: 1-14.
  23. Tsay SL, Chao YF. Effect of perceived self efficacy and functional status on depression in patients with chronic heart failure. J Nurs Res 2002; 10: 271-8.
  24. Sullivan G, Crasske MG, Shurbourne C, Edlund MJ,Rose RD, Golinelli D, and et al. Design of  Coordinated Anxiety Learning and Management (CALM) study: innovations in collaborative care for anxiety disorders. General Hospital Psychiatry 2007; 29: 379-87.
  25. Hegel MT, Unutzer J, Tang L, Arean PA, Katon W, Noel PH, Williams JW, Lin EH. Impact of comorbid panic and posttraumatic stress disorder on outcomes of collaborative care for late-life depression in primary care. Am Geriatr Psychiatry. 2005; 13(1): 48-58.
  26. Chew-Graham CA, Lovell K, Roberts C, Baldwin R, Morely M, Burns A, Richards D, Burroughs H. A randomized controlled trial to test the feasibility of a collaborative care model for management of depression in older people. Br J Pract. 2007; 57(538): 364-70.
  27. Sullivan MJ,  wood L, Terry J, Brantley J, Charles A, McGee V, Diane J, Krucoff MW, and et al. The support, Education, and research in chronic Heart Failure Study (SEARCH): A mindfulness-based psycho educational intervention improves depression and clinical symptoms in patients with chronic heart failure. Am Heart J 2009; 157(1):84-90.
  28. Cully JA, Jimenez DE, Ledux TA, and Deswal A. recognition and treatment of depression and anxiety symptoms in heart failure. Pain care companion J clin Psychiatry 2009; 11(3).