Date of Award

January 2012

Document Type

Open Access Thesis

Degree Name

Master of Science in Nursing (MSN)

Department

Yale University School of Nursing

First Advisor

Nancy S. Redeker

Abstract

In this secondary analysis of cross sectional data collected from 173 patients with chronic HF the demographic, clinical, and sleep related factors present in patients with stable HF and major depressive disorder (MDD) were explored. Participants were recruited from 5 structured HF disease management programs in the Northeastern US. Measures include the Centers for Epidemiological Studies Depression Scale (CESD), the Charlson Comorbidity Index (CCI), and a sleep diary. Results indicate significant between group differences between patients with MDD and without MDD in age, gender, NYHA, diabetes, chronic fatigue, asthma, past psychiatric history, antidepressant use, anxiolytic use, insomnia, and taking sleeping pills. A logistic regression incorporating age, gender, NYHA class, asthma, diabetes, and insomnia predicted 84.6% of patients with and without MDD, with insomnia remaining significant at a p = 0.002. Major Depressive Disorder (MDD) is a common and under-diagnosed co-morbidity in stable heart failure (HF), associated with worse outcomes and lower quality of life. Further identification of the factors associated with MDD in patients with stable HF may help to improve rates of diagnosis and treatment. Self reported insomnia was present in the majority of depressed patients. Other characteristics of depressed patients in the sample include younger age, female gender, NYHA class III/IV, and co-morbid asthma and diabetes.

Comments

This is an Open Access Thesis.

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