Gender Differences in Patients with Anxiety after Coronary Artery Bypass Surgery
Objective: The present study was designed to evaluate the relationship between gender and coexisting anxiety in patients undergoing coronary artery surgery.Â
Materials and Methods: A total of 137 patients
(41 women and 96 men with a mean age 66.1 Â± 6.0 years) patients underwent state and trait anxiety evaluation at baseline (preoperatively) and at six months after (postoperatively) coronary artery bypass graft (CABG). Anxiety symptoms were assessed at enrollment using the Spielberger State-Trait Anxiety Inventory (STAI). Psychological, social, clinical, and surgical data were assessed statistically.Â
Results: There were statistically significant differences between female and male patient characteristics for the mean age, mean education year, and mean body mass index. The women were found to be statistically younger and less educated, and more likely to be overweight, diabetic, and hyperlipidemic. The mean hospitalization time, wound infection, and extreme postoperative pain complaints were found to be higher in the female group. 61 patients (33 female and
28 male) (44.5%) were classified as presenting clinically significant anxiety symptoms (STAI score of â‰¥ 40). The female patients’ STAI scores were significantly higher than men in state and trait anxiety, both preoperatively and six months postoperatively. Postoperatively, there was not any significant decrease in the level of trait anxiety when comparing the level of state anxiety in female patients. Â
Conclusion: Even after adjusting for known risk factors for compromised STAI, women do not show the same long-term quality benefits of CABG surgery that men do. The results indicate that the STAI is a valuable instrument for identifying and supporting patients with higher levels of anxiety, which can aid in determining patients that may have poor adjustment after CABG surgery.
Allen JK, Xu X. 1997. Coronary revascularization in women. Crit Care Nurs Clin North Am 9:497–509.
Bagheri J, Sarzaeem MR, Valeshabad AK, et al. 2014. Effect of sex on early outcomes of isolated coronary artery bypass grafting. Turk Gogus Kalp Dama 22:534-9.
Brummett BH, Barefoot JC, Siegler IC, et al. 2001. Characteristics of socially isolated patients with coronary artery disease who are at elevated risk for mortality. Psychosom Med 63:267–72.
Burker EJ, Blumenthal JA, Feldman M, et al. 1995. Depression in male and female patients undergoing cardiac surgery. British J Clin Psych 34:119–28.
Cannistra LB, Balady GJ, O’Malley CJ, et al. 1992. Comparison of the clinical profile and outcome of women and men in cardiac rehabilitation. Am J Cardiol 69:1274–9.
Cebeci F, Celik SS. 2011. Effect of discharge teaching and counselling on anxiety and depression level of coronary artery bypass graft patients. Turk Gogus Kalp Dama 19:176-9.
Cronin SN, Logsdon C, Miracle V. 1997. Psychosocial and functional outcomes in women after coronary artery bypass surgery. Crit Care Nurse 17:19–24.
Duits AA, Boeke S, Taams MA, et al. 1997. Prediction of quality of life after coronary artery bypass graft surgery: a review and evaluation of multiple, recent studies. Psychosom Med 59:257–68.
Friedmann E, Thomas SA, Liu F, et al. 2006. Sudden cardiac death in heart failure trial investigators. Relationship of depression, anxiety, and social isolation to chronic heart failure outpatient mortality. Am Heart J 152:940.e1–8.
Greszta E, Sieminska MJ. 2008. Relationship of preoperative anxiety-state and anxiety-trait in patients qualified for coronary artery bypass graft surgery to the perception of postoperative pain and other pain complaints. Ann Acad Med Stetin 54:157-63.
Hawthorne MH. 1994. Gender differences in recovery after coronary artery surgery. Image J Nurs Sch 26:75–80.
Hemingway H, Marmot M. 1999. Evidence based cardiology: psychosocial factors in the aetiology and prognosis of coronary heart disease: systematic review of prospective cohort studies. BMJ 318:1460–7.
Higgins TL, Estafanous FG, Loop FD, et al. 1992. Stratification of morbidity and mortality outcome by preoperative risk factors in coronary artery bypass patients. A clinical severity score. JAMA 267:2344–8.
Hunt JO, Hendrata MV, Myles PS. 2000. Quality of life 12 months after coronary artery bypass graft surgery. Heart Lung 29:401–11.
Jacobs AK, Kelsey SF, Brooks MM, et al. 1998. Better outcome for women compared with men undergoing coronary revascularization: a report from the bypass angioplasty revascularization investigation (BARI). Circulation 98:1279–85.
Kawachi I, Sparrow D, Vokonas PS, et al. 1995. Decreased heart rate variability in men with phobic anxiety (data from the normative aging study). Am J Cardiol 75:882–5.
King KM. 2000. Gender and short-term recovery from cardiac surgery. Nurs Res 49:29–36.
Kubzansky LD, Cole SR, Kawachi I, et al. 2006. Shared and unique contributions of anger, anxiety, and depression to coronary heart disease: A prospective study in the normative aging study. Ann Behav Med 31:21–9.
Moore SM. 1995. A comparison of women’s and men’s symptoms during home recovery after coronary artery bypass surgery. Heart Lung 24:495–501.
Musselmann DL, Evans D, Nemeroff CB. 1998. The relationship of depression to cardiovascular disease. Arch Gen Psychiatr 55:580–92.
Rankin SH. 1990. Differences in recovery from cardiac surgery: a profile of male and female patients. Heart Lung 19:481–5.
Rothenhausler HB, Grieser B, Nollert G, et al. 2005. Psychiatric and psychosocial outcome of cardiac surgery with cardiopulmonary bypass: a prospective 12-month follow-up study. Gen Hosp Psychiatry 27:18–28.
Rymaszewska J, Kiejna A, Hadrys T. 2003. Depression and anxiety in coronary artery bypass grafting patients. Eur Psychiatry 18:155–60.
Speilberger CG, Lushene R. 1970. State-Trait Anxiety Inventory manual. Palo Alto, CA: Consulting Psychologists Press.
Steine S, Laerum E, Eritsland J, et al. 1996. Predictors of enhanced well-being after coronary artery bypass surgery. J Intern Med 239:69–73.
Suls J, Bunde J. 2005. Anger, anxiety, and depression as risk factors for cardiovascular disease: The problems and implications of overlapping affective dispositions. Psychol Bull 131:260–300.
SzÃ©kely A, Balog P, BenkÃ¶ E, et al. 2007. Anxiety predicts mortality and morbidity after coronary artery and valve surgery a 4-year follow-up study. Psychosom Med 69:625–31.
Tully PJ, Baker RA, Knight JL. 2008. Anxiety and depression as risk factors for mortality after coronary artery bypass surgery. J Psychosom Res 64:285–90.
Wellenius GA, Mukamal KJ, Kulshreshtha A, et al. 2008. Depressive symptoms and the risk of atherosclerotic progression among patients with coronary artery bypass grafts. Circulation 117:2313–9.
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