title: Factors associated with anxiety and depression among patients with implantable cardioverter defibrillator.
abstract: OBJECTIVE
  To identify factors associated with anxiety and depression of patients with implantable cardioverter defibrillators.
  
  
  BACKGROUND
  Implantable cardioverter defibrillator is effective to increase survival from life-threatening arrhythmias, but it lowers health-related quality of life. Anxiety and depression had significant negative association with health-related quality of life. However, knowledge about factors associated with these two negative emotions in this specific population is inadequate.
  
  
  METHODS
  A cross-sectional descriptive design was conducted. Secondary analysis was performed to address the aim.
  
  
  METHODS
  A convenience sampling of patients with implantable cardioverter defibrillators was performed. Anxiety and depression were measured by the Hospital Anxiety and Depression Scale through face-to-face interview.
  
  
  RESULTS
  Stepwise multivariable regression results showed that older age (aged 60-69 and ≥70: B = 2·08 and 3·31, p = 0·039 and <0·001), self-care dependence (B = 3·47, p < 0·001), being married (B = -2·21, p = 0·004) and having ischaemic heart disease (B = -1·80, p = 0·008) were significantly associated with depression. However, there was no significant factor associated with anxiety.
  
  
  CONCLUSIONS
  Factors associated with depression among patients with implantable cardioverter defibrillator are identified. Older age (aged ≥60) and more self-care dependence have positive, but being married and having ischaemic heart disease have negative association with depression. Strategies to reduce psychological distress are highlighted.
  
  
  CONCLUSIONS
  The study findings direct the care to improve health-related quality of life by reducing and controlling vulnerabilities arising from depression. Patients who are older people (≥aged 60) and more self-care dependent perceive higher depression. Nursing strategies are suggested to reduce depression especially for those who are older people and more self-care dependent. Early screening is essential to provide immediate care for reducing vulnerabilities arising from depression. Performing comprehensive assessment for self-care ability and providing adequate assistance are crucial. Family involvement may reduce depression through providing physical and psychosocial support.
authors.affiliation: The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China.
authors.forename: Mei Fung Florence
authors.initials: MF
authors.lastname: Wong
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000523:psychology*; D001145:Arrhythmias, Cardiac / Q000628:therapy; D003430:Cross-Sectional Studies; D017147:Defibrillators, Implantable / Q000009:adverse effects / Q000523:psychology*; D003863:Depression / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology*
keywords: anxiety; associated factors; cardiac nursing; depression; implantable cardioverter defibrillator