title: Comparing the psychological stress between non-smoking patients and smoking patients who experience abrupt smoking cessation during hospitalization for acute myocardial infarction: a pilot study.
abstract: BACKGROUND
  Stress is an untoward condition in patients with acute myocardial infarction (AMI). Abrupt nicotine withdrawal is associated with increased symptoms of stress. However, little is known about the impact of smoking cessation on the psychological indicators of stress among hospitalized AMI patients.
  
  
  OBJECTIVE
  In this pilot study we compared the psychological stressors between non-smoking AMI patients and smoking patients who abruptly ceased smoking following admission to the CCU.
  
  
  METHODS
  A cross-sectional survey was piloted on a sample of 57 AMI patients (29 smokers and 28 nonsmokers) on the second day of admission to the CCU. Psychological stress was measured using the Profile of Mood States and the Insomnia Severity Index.
  
  
  RESULTS
  Multivariate analysis of covariance (MANCOVA) suggested that after adjusting for age, smokers experienced significantly higher overall levels of stress than non-smokers (F = 3.13; p = 0.016). Post-hoc analyses suggested that scores of depression (p = 0.033), anxiety (p = 0.007), and anger (p = 0.017) were particularly higher among smokers, as compared to non-smokers. However, the two groups were not different with regard to their scores on fatigue (p = 0.528) and insomnia (p = 0.299).
  
  
  CONCLUSIONS
  Abrupt smoking cessation may expose patients admitted with AMI symptoms to higher levels of psychological stress. Given the potential damaging impact of psychological stressors on the physical outcomes of these patients, these findings demonstrate the need for continued assessment and research related to the management of nicotine withdrawal following AMI.
authors: University of Windsor, Faculty of Nursing, 401 Sunset, Health Education Center, Windsor, Ontario, N9B 3P4. kpfaff@uwindsor.ca
authors: Kathryn A
authors: KA
authors: Pfaff
authors: Maher M
authors: MM
authors: El-Masri
authors: Susan M
authors: SM
authors: Fox-Wasylyshyn
mesh_terms: D000223:Adaptation, Psychological; D000786:Anger; D001294:Attitude to Health; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D003863:Depression / Q000523:psychology; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D007297:Inpatients / Q000523:psychology*; D008297:Male; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000150:complications / Q000523:psychology*; D015404:Nursing Methodology Research; D009864:Ontario / Q000453:epidemiology; D010865:Pilot Projects; D012907:Smoking / Q000009:adverse effects / Q000523:psychology*; D016540:Smoking Cessation / Q000523:psychology*; D000074606:Smoking Prevention; D013315:Stress, Psychological / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000523:psychology*; D011795:Surveys and Questionnaires