title: Effects of stress, health competence, and social support on depressive symptoms after cardiac hospitalization.
abstract: Little is known about the role of stress on the psychological well-being of patients after cardiac hospitalization or about factors that protect against or exacerbate the effects of stress. We use prospective data from 1542 patients to investigate the relationship between post-discharge stress and changes in depressive symptoms, and whether the level of prior depressive symptoms, health competence, and perceived social support moderate this relationship. Net of depressive symptoms in the 2 weeks prior to hospitalization, higher levels of post-discharge stress significantly increase depressive symptoms 30 days after discharge. The level of prior depressive symptoms moderates the effect of stress. On the other hand, perceived health competence and social support buffer the negative effects of post-discharge stress. Knowing which patients are particularly vulnerable to experiencing stress and a subsequent increase in depressive symptoms can help trigger interventions prior to discharge and possibly ameliorate the prevalence of depression.
authors.affiliation: Department of Sociology, Vanderbilt University, PMB 351811, Nashville, TN, 37235-1811, USA. g.leonperez@vanderbilt.edu.
authors.forename: Gabriela
authors.initials: G
authors.lastname: León-Pérez
authors.affiliation: School of Nursing, Vanderbilt University, Nashville, TN, USA.
authors.forename: Kenneth A
authors.initials: KA
authors.lastname: Wallston
authors.affiliation: Center for Health Services Research, Vanderbilt University Medical Center, Nashville, TN, USA.
authors.forename: Kathryn M
authors.initials: KM
authors.lastname: Goggins
authors.affiliation: Center for Health Services Research, Vanderbilt University Medical Center, Nashville, TN, USA.
authors.forename: Heidi M
authors.initials: HM
authors.lastname: Poppendeck
authors.affiliation: Department of Medicine, Center for Clinical Quality and Implementation Research, Vanderbilt University Medical Center, Nashville, TN, USA.
authors.forename: Sunil
authors.initials: S
authors.lastname: Kripalani
mesh_terms: D054058:Acute Coronary Syndrome / Q000523:psychology* / Q000628:therapy; D000368:Aged; D003863:Depression / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D007722:Health Knowledge, Attitudes, Practice; D006333:Heart Failure / Q000523:psychology* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D012944:Social Support; D013315:Stress, Psychological / Q000523:psychology*
keywords: Depressive symptoms; Health competence; Heart disease; Social support; Stress