Psychosocial outcomes of Hong Kong Chinese diagnosed with acute coronary syndromes : A prospective repeated measures study

Background
Western studies have suggested that emotional stress and distress impacted on the morbidity and mortality in people following acute coronary events. Symptoms of anxiety and depression have been associated with re-infarction and death, prolonged recovery and disability and depression may precipitate the client's low self-esteem. This study examined perceived anxiety, depression and self-esteem of Hong Kong Chinese clients diagnosed with acute coronary syndrome (ACS) over a 6-month period following hospital admission.

Objectives
To examine:
(1)clients’ perception of anxiety, depression and self-esteem following hospital admission with ACS in Hong Kong;
(2)associations between these psychosocial status and clients’ socio-demographic characteristics; and
(3)changes in these psychosocial status from admission to 6 months post-discharge.

Design
A prospective, repeated measures design with measures taken on two occasions over a 6-month period; (1) within the 1st week of hospital admission following the onset of ACS and (2) at 6 months follow up.

Setting and participants
Convenient sample of 182 voluntary consented clients admitted with ACS to a major public hospital in Hong Kong who could communicate in Chinese, complete questionnaires, cognitive intact, and were haemodynamically stable and free from acute chest pain at the time of interview.

Methods
Baseline data were obtained within 1 week after hospital admission. The follow-up data was collected 6 months after hospital discharge. The Chinese version of the Hospital Anxiety and Depression Scale (HADS), State Self-esteem Scale (SSES), and Rosenberg's Self-Esteem Scale (RSES) were used to assess anxiety and depression, state self-esteem, and trait self-esteem, respectively.

Results
Findings suggested gender differences in clients’ perception in anxiety, depression and self-esteem. Improvements in clients’ perception of these variables were evident over the 6-month period following their acute coronary events.

Conclusion
The study confirmed the western notion that psychosocial problems are common among coronary clients and this also applies to Hong Kong Chinese diagnosed with ACS. Further studies to explore effective interventions to address these psychosocial issues are recommended.

Copyright © 2006 Elsevier Ltd. All rights reserved.