Abstract

Purpose: To explore the effect of reactive depression on all-cause rehospitalization and all-cause mortality in NYHA Class III and IV patients during the 12 month following an index hospitalization for HF exacerbation. The study aims were: (a) describe the effect of depression, (b) explain the variance of depression, and (c) determine the moderator effect of depression on patient preparedness to manage complex HF home care all-cause rehospitalization and/or all-cause mortality in HF patients.

Methods: A Secondary Data Analysis of data obtained from a longitudinal study. Descriptive statistics, logistic regression, and multiple linear regression analyses with and with/out interaction effects were performed to address the study purpose and aims. Wagner's Chronic Care Model provided the theoretical framework that guided the study. Instruments included in this study: demographic sheet, the Center for Epidemiological Studies Depression Scale (CES-D), and the Dartmouth Primary Care Cooperative Information Project Chart System (measure social support), Income Adequacy rating scale, Preparedness for HF Home Care, and a medical record review for determining the comorbidities index score.

Results: Logistic regression, multiple regression, and moderator analysis were conducted to address the research questions. These analyses demonstrated that depression consistently has a significant relationship to rehospitalization. Depression as measured by CES-D score greater or equal than 16 has a significant relationship with all-cause rehospitalization p=.09 and all-cause rehospitalization and mortality p=.09. In this study, depression did not demonstrate a relationship with mortality alone. In addition, depression did not have an interaction effect between preparedness and all-cause rehospitalization and/or mortality.

Conclusion: A significant relationship was identified between depression and all cause readmission. The relationship between depression and the composite variable (all cause readmission and mortality) was also significant due to all cause readmission alone. This further supports the strength of the relationship between depression and rehospitalization. Screening for depression should be part of heart failure management. Management of depression may decrease rehospitalization in HF patients.

Author Details

Mary Renee Walters, PhD, RN, CCRN, FNP-BC

Sigma Membership

Delta

Type

Poster

Format Type

Text-based Document

Study Design/Type

N/A

Research Approach

N/A

Keywords:

Heart Failure, Outcomes and Rehospitalization, Mortality

Conference Name

28th International Nursing Research Congress

Conference Host

Sigma Theta Tau International

Conference Location

Dublin, Ireland

Conference Year

2017

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.

All permission requests should be directed accordingly and not to the Sigma Repository.

All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Acquisition

Proxy-submission

Additional Files

download (290 kB)

download (146 kB)

Share

COinS
 

Reactive depression's relationship to rehospitalization in heart failure patients

Dublin, Ireland

Purpose: To explore the effect of reactive depression on all-cause rehospitalization and all-cause mortality in NYHA Class III and IV patients during the 12 month following an index hospitalization for HF exacerbation. The study aims were: (a) describe the effect of depression, (b) explain the variance of depression, and (c) determine the moderator effect of depression on patient preparedness to manage complex HF home care all-cause rehospitalization and/or all-cause mortality in HF patients.

Methods: A Secondary Data Analysis of data obtained from a longitudinal study. Descriptive statistics, logistic regression, and multiple linear regression analyses with and with/out interaction effects were performed to address the study purpose and aims. Wagner's Chronic Care Model provided the theoretical framework that guided the study. Instruments included in this study: demographic sheet, the Center for Epidemiological Studies Depression Scale (CES-D), and the Dartmouth Primary Care Cooperative Information Project Chart System (measure social support), Income Adequacy rating scale, Preparedness for HF Home Care, and a medical record review for determining the comorbidities index score.

Results: Logistic regression, multiple regression, and moderator analysis were conducted to address the research questions. These analyses demonstrated that depression consistently has a significant relationship to rehospitalization. Depression as measured by CES-D score greater or equal than 16 has a significant relationship with all-cause rehospitalization p=.09 and all-cause rehospitalization and mortality p=.09. In this study, depression did not demonstrate a relationship with mortality alone. In addition, depression did not have an interaction effect between preparedness and all-cause rehospitalization and/or mortality.

Conclusion: A significant relationship was identified between depression and all cause readmission. The relationship between depression and the composite variable (all cause readmission and mortality) was also significant due to all cause readmission alone. This further supports the strength of the relationship between depression and rehospitalization. Screening for depression should be part of heart failure management. Management of depression may decrease rehospitalization in HF patients.