Introduction
Methods
Study setting and period
Study design
Study population
Eligibility criteria
Sample size and sampling procedure
Variables
Dependent variable
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Depression (Yes/No).
Independent variables
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Socio-demographic characteristics included: age, sex, educational status, marital status, residence, employment status, social support, health insurance.
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Clinical and other related characteristics included: comorbidity, New York Heart Association (NYHA) class, duration of illness, history of hospitalisation, number of medications taken each day, family history of heart failure, overall health perception.
Operational definitions and definitions of terms
Data collection procedure and instruments
Data analysis
Results
Sociodemographic characteristics of the study participants
Variables | Category | Frequency (%) |
---|---|---|
Age | 18–39 | 74 (19.32) |
40–69 | 222 (57.96) | |
≥70 | 87 (22.72) | |
Sex | Male | 184 (48.04) |
Female | 199 (51.96) | |
Marital status | Single | 65 (16.97) |
Married | 196 (51.17) | |
Divorced | 33 (8.62) | |
Widowed | 69 (18.02) | |
Separated | 20 (5.22) | |
Employment status | Employed | 184 (48.04) |
Unemployed | 199 (51.96) | |
Residence | Urban | 286 (74.67) |
Rural | 97 (25.33) | |
Educational level | Low or no education | 114 (29.77) |
Primary education | 108 (28.20) | |
Secondary education | 87 (22.72) | |
College and above | 74 (19.32) | |
Community health insurance | Yes | 276 (72.06) |
No | 107 (27.94) |
Clinical characteristics of the study participants
Variables | Category | Frequency (%) |
---|---|---|
Family history of heart failure | No | 336 (87.73) |
Yes | 47 (12.27) | |
History of hospitalisation in the last 12 months | No | 251 (65.54) |
Yes | 132 (34.46) | |
Comorbidities | ||
Hypertension | Yes | 169 (44.13) |
Diabetes | Yes | 80 (20.89) |
Kidney disease | Yes | 29 (7.57) |
COPD and asthma | Yes | 11 (2.87) |
Cancer | Yes | 3 (0.78) |
HIV/AIDS | Yes | 19 (4.96) |
Length of time since HF diagnosis | < 1year | 65 (16.97) |
1–5 years | 154 (40.21) | |
5–10 years | 107 (27.94) | |
10–15 years | 34 (8.88) | |
> 15 years | 23 (6.01) | |
Medications taken daily | < 5 | 276 (72.06) |
≥ 5 | 107 (27.94) | |
NYHA class | Class I | 135 (35.25) |
Class II | 117 (30.55) | |
Class III | 93 (24.28) | |
Class IV | 38 (9.92) | |
General health perception | Excellent | 32 (8.36) |
Very good | 102 (26.63) | |
Fair | 149 (38.90) | |
Poor | 100 (26.11) | |
Social support scores | Mean ± SD | 8.98 ± 2.94 |
The PHQ-9 scale scores and the prevalence of depression among participants
PHQ-9 items | Frequency (%) | |||
---|---|---|---|---|
How often have you bothered by any of the following problems over the last 2 weeks? | Not at all | Several days | More than half the days | Nearly everyday |
Little interest or pleasure in doing things | 94 (24.54) | 136 (35.51) | 109 (28.46) | 44 (11.49) |
Feeling down, depressed, or hopeless | 122 (31.85) | 125 (32.64) | 72 (18.80) | 64 (16.71) |
Trouble falling or staying asleep, or sleeping too much | 109 (28.46) | 117 (30.55) | 99 (25.85) | 58 (15.14) |
Feeling tired or having little energy | 16 (4.18) | 104 (27.15) | 123 (32.11) | 140 (36.55) |
Poor appetite or overeating | 107(27.94) | 115 (30.03) | 103 (26.89) | 58 (15.14) |
Feeling bad about yourself or that you are a failure or have let yourself or your family down | 130 (33.94) | 111 (28.98) | 66 (17.23) | 76 (19.84) |
Trouble concentrating on things, such as reading the newspaper or watching television | 175 (45.69) | 120 (31.33) | 62 (16.19) | 26 (6.79) |
Moving or speaking so slowly that other people could have noticed. | 117 (30.55) | 120 (31.33) | 78 (20.37) | 68 (17.75 |
Thoughts that you would be better off dead, or of hurting yourself | 232 (60.57) | 77 (20.10) | 53 (13.84) | 21 (5.48) |
Factors associated with comorbid depression in adults with heart failure
Variables | Depression | COR (95%CI) | AOR (95%CI) | P-value | |
---|---|---|---|---|---|
Yes N (%) | No N (%) | ||||
Age | |||||
18–39 | 38(17.51) | 36(21.69) | 1 | 1 | |
40–69 | 124(57.14) | 98(59.04) | 1.20(0.71,2.03) | 0.71 (0.34,1.46) | 0.346 |
≥70 | 55(25.35) | 32(19.28) | 1.63(0.87,3.06) | 0.49 (0.19,1.28) | 0.145 |
Sex | |||||
Male | 90(41.47) | 94(56.63) | 1 | 1 | |
Female | 127(58.53) | 72(43.37) | 1.84(1.22,2.77) | 2.31 (1.30,4.08) | 0.004* |
Marital status | |||||
Single | 34(15.67) | 31(18.67) | 0.88(0.50,1.54) | 1.09(0.53,2.25) | 0.808 |
Married | 109(50.23) | 87(52.41) | 1 | 1 | |
Divorced | 23(10.60) | 10(6.02) | 1.84(0.83,4.06) | 1.53(0.54,4.29) | 0.423 |
Widowed | 41(18.89) | 28(16.87) | 1.17(0.67,2.04) | 0.81(0.37,1.78) | 0.603 |
Separated | 10(4.61) | 10(6.02) | 0.80(0.32,2.00) | 0.51(0.16,1.65) | 0.260 |
Educational level | |||||
Illiterate | 71(32.72) | 43(25.90) | 1 | 1 | |
Primary | 69(31.80) | 39(23.49) | 1.07(0.62,1.85) | 0.76(0.37,1.60) | 0.458 |
Secondary | 40(18.43) | 47(28.31) | 0.52(0.29,0.91) | 0.62(0.29,1.30) | 0.204 |
College & above | 37(17.05) | 37(22.29) | 0.61(0.33,1.10) | 0.96(0.41,2.24) | 0.928 |
Diabetes mellitus | |||||
No | 150(69.12) | 153(92.17) | 1 | 1 | |
Yes | 67(30.88) | 13(7.83) | 5.26(2.79,9.92) | 3.16(1.47,6.82) | 0.003* |
COPD | |||||
No | 208(95.85) | 164(98.80) | 1 | 1 | |
Yes | 9(4.15) | 2(1.20) | 3.55(0.76,16.65) | 2.43(0.41,14.49) | 0.329 |
NYHA class | |||||
Class I | 62(28.57) | 73(43.98) | 1 | 1 | |
Class II | 62(28.11) | 56(33.73) | 1.28(0.78,2.11) | 1.00(0.54,1.87) | 0.997 |
Class III | 62(28.11) | 32(19.28) | 2.24(1.30,3.78) | 1.59(0.78,3.23) | 0.204 |
Class IV | 33(15.21) | 5(3.01) | 7.77(2.86,21.12) | 3.59(1.05,12.30) | 0.042* |
Social support | |||||
Poor | 123(56.68) | 35(21.08) | 7.14(4.05,12.57) | 6.04(2.97,12.32) | 0.001* |
Moderate | 62(28.57) | 66(39.76) | 1.91(1.10,3.29) | 1.78(0.89,3.57) | 0.103 |
Strong | 32(14.75) | 65(39.16) | 1 | 1 | |
Employment status | |||||
Employed | 87(40.09) | 97(58.43) | 1 | 1 | |
Unemployed | 130(59.91) | 69(41.57) | 2.10(1.39,3.17) | 1.18(0.67,2.09) | 0.562 |
Hospitalisation History | |||||
No | 134(61.75) | 117(70.48) | 1 | 1 | |
Yes | 83(38.25) | 49(29.52) | 1.48(0.96,2.28) | 1.05(0.60,1.83) | 0.863 |
Number of medications daily | |||||
<5 | 133(61.29) | 143(86.14) | 1 | 1 | |
≥5 | 84(38.71) | 23(13.86) | 3.93(2.34,6.59) | 5.26(2.72,10.18) | 0.001* |
Health perception | |||||
Excellent | 11(5.07) | 21(12.65) | 1 | 1 | |
Very good | 36(16.59) | 66(39.76) | 1.04(0.45,2.40) | 1.24(0.44,3.44) | 0.684 |
Fair | 93(42.86) | 56(33.73) | 3.17(1.42,7.07) | 3.50(1.29,9.52) | 0.014* |
Poor | 77(35.48) | 23(13.86) | 6.39(2.69,15.19) | 4.74(1.64,13.73) | 0.004* |