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Psychological distress and healthcare use in patients with non-cardiac chest pain: does a history of cardiac disease matter?
Linköping University, Department of Social and Welfare Studies, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.ORCID iD: 0000-0001-9140-8922
Linköping University, Department of Social and Welfare Studies, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Cardiology in Linköping.ORCID iD: 0000-0002-4259-3671
Formerly Swedish Defence Research Agency, Stockholm, Sweden.
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2017 (English)In: Abstract book, Sage Publications, 2017, Vol. 16 (S1), p. S3-S3, article id 24Conference paper, Poster (with or without abstract) (Other academic)
Abstract [en]

Background: Patients with non-cardiac chest pain (NCCP) suffer psychological distress such as somatization, fear of body sensations, cardiac anxiety and depressive symptoms, which can increase healthcare use. It is unknown how these variables are related and whether the relationships differ between patients with or without history of cardiac disease.

Objective: To explore and model the associations between somatization, fear of body sensations, cardiac anxiety, depressive symptoms, and healthcare use in patients with NCCP with or without history of cardiac disease.

Methods: Data were collected in Sweden in 670 patients (mean age 65±16 years, 51% women) within one month from discharge using the Patient Health Questionnaire-15, Body Sensations Questionnaire, Cardiac Anxiety Questionnaire, and Patient Health Questionnaire-9. Structural Equation Modelling analyses were used to explore the relationships between somatization, fear of body sensations, cardiac anxiety, depressive symptoms and healthcare use in NCCP patients with or without history of cardiac disease.

Results: About 40% of the NCCP patients had previous diagnosis of cardiac disease. Patients with NCCP and a history of cardiac disease were older (71 vs. 60 years), had more comorbidities (4.7 vs. 2.8), and reported significantly higher scores in somatization (p=0.02), cardiac anxiety (p<0.001), and depressive symptoms (p=0.02), and greater healthcare use (p<0.001). Depressive symptoms were not directly associated with healthcare use (Chi-Square=68.28, df=10, P-value=0.000, RMSEA=0.099, CFI=0.96). In patients with history of cardiac disease, the impact of depressive symptoms on healthcare use was mediated by somatization, fear of body sensations, and cardiac anxiety (Chi-Square=7.61, df=8, P-value=0.48, RMSEA=0.000, CFI=0.99). In patients with no history of cardiac disease, the impact of depressive symptoms on healthcare use was directly mediated by cardiac anxiety (Chi-Square=4.17, df=7, P-value=0.76, RMSEA=0.000, CFI=0.99).

Conclusions: The associations between psychological distress and healthcare use were different for patients with or without cardiac disease. In both groups depressive symptoms had no direct association with healthcare use.

Place, publisher, year, edition, pages
Sage Publications, 2017. Vol. 16 (S1), p. S3-S3, article id 24
Series
European Journal Of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953
National Category
Other Medical Sciences
Identifiers
URN: urn:nbn:se:liu:diva-142715OAI: oai:DiVA.org:liu-142715DiVA: diva2:1153890
Conference
EuroHeartCare, Jönköping, Sweden, 18-20 May 2017
Funder
Region ÖstergötlandMedical Research Council of Southeast Sweden (FORSS)
Available from: 2017-10-31 Created: 2017-10-31 Last updated: 2017-12-04Bibliographically approved

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Mourad, GhassanJaarsma, TinyStrömberg, AnnaJohansson, Peter

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