Abstract
AimsTo describe prevalence of symptoms of anxiety and depression in surgical patients at three time points: at hospital postsurgery (T1), 6 weeks (T2) and 6 months (T3) postdischarge from hospital; and detect situations and experiences that predict symptoms of anxiety and depression at T2 and T3.DesignProspective, explorative two‐site follow‐up study.MethodsPatients having selected surgeries from January–July 2016 were invited to participate. Final participation was 390 patients. Participation involved answering questionnaires, including the Hospital Anxiety and Depression Scale (HADS). A stepwise multiple linear regression model was employed to calculate predictors of anxiety and depression.ResultsThe proportion of patients presenting with moderate‐to‐severe anxiety or depression ranged from 5.4%–20.2% at different times. Major predictors of anxiety at both times were not feeling rested upon awakening and higher scores on HADS‐Anxiety at T1 and T2 and at T2 also experiencing more distressing postoperative symptoms. For depression, the major predictors were at both times higher scores on HADS‐Depression at T2 and T3 and also at T2 not feeling rested upon awakening and at T3 reporting delayed or very delayed recovery.The four models explained from 43.9%–55.6% of the variance in symptoms of anxiety and depression. Our findings show that patients presenting with psychological distress at the hospital are in a vulnerable position. Also, that benefits of good sleep during the recovery should be emphasized during hospital stay.
Highlights
The long-term aim of nursing care for surgical patients is to safely deliver a recovered patient back to society or his/her normal activities
Eligible for participation were patients who had elective cardiac or pulmonary surgery or urological, gastrointestinal or orthopaedic surgery at Landspitali University Hospital (LUH) and orthopaedic surgery at Akureyri Hospital (AH) from 15 January–15 July 2016, who could read and write Icelandic, who stayed at the hospital overnight, who were discharged home, who were at home six weeks and 6 months postdischarge, and who were assessed by nurses as eligible for participation based on the patients' mental capacity and degree of physical state at the time
This study indicates that surgical patients who present with psychological distress during hospitalization are likely to show these symptoms up to 6 months postdischarge
Summary
The long-term aim of nursing care for surgical patients is to safely deliver a recovered patient back to society or his/her normal activities. Outcome measurements of surgery and care are often rehospitalization (Fischer et al 2014), length of stay at the hospital (Lingsma et al, 2018), return to work/normal activities and resolution of various symptoms depending on the disease leading to surgery (Lee, Tran, Mayo, Carli, & Feldman, 2014). This can be influenced by the patient's health in general, family and social situation, age and gender (Lee et al, 2014). Routine methods to detect those at risk for long-term psychological distress should be implemented and those at risk followed for at least 6 months. Due to the health consequences of untreated depression/anxiety, those who meet criteria for having moderate-to-severe symptoms should be referred to appropriate health professionals for medical or psychological treatment
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