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Using the cardiac depression scale in men recovering from coronary artery bypass surgery
Kathryn M King1, Tracey J F Colella, Peter Faris
1Faculty of Nursing, University of Calgary, Calgary, AB, Canada. kingk@ucalgary.ca
Insights
The Cardiac Depression Scale shows promise for assessing depression in patients after coronary artery bypass graft surgery. While continuous scores correlate well with the Beck Depression Inventory, agreement on dichotomized scores needs further study.
Area of Science:
- Cardiology
- Psychiatry
- Medical Psychology
Background:
- The Beck Depression Inventory may lack sensitivity for cardiac patients.
- The Cardiac Depression Scale is designed to assess depression in medical cardiac patients.
Purpose of the Study:
- To validate the Cardiac Depression Scale for patients undergoing first-time coronary artery bypass graft (CABG) surgery.
- To compare the utility of the Cardiac Depression Scale against the Beck Depression Inventory in this population.
Main Methods:
- A survey design was employed.
- 120 male patients completed the Beck Depression Inventory and Cardiac Depression Scale at discharge and 6, 12, and 36 weeks post-surgery.
- Statistical analyses included Cronbach's alpha, repeated measures ANOVA, Pearson correlations, and Cohen's Kappa.
Main Results:
- Both scales demonstrated good internal consistency.
- Depression scores decreased significantly over time for both measures.
- Continuous scores showed high correlation, but agreement on dichotomized scores (depression/no depression) was less impressive.
Conclusions:
- The Cardiac Depression Scale appears to have utility in assessing depression among surgical cardiac patients.
- Further research is recommended to fully establish the measure's validity and application.
- Utilizing a cardiac-specific depression measure may improve identification of depression in this vulnerable group.
Aims:
To examine the utility and validate the use of the Cardiac Depression Scale in patients who had first-time coronary artery bypass graft surgery.
Background:
The Beck Depression Inventory, though frequently used, may not be sufficiently sensitive for use in cardiac patients. The Cardiac Depression Scale has been shown to identify the range of depression in medical cardiac patients.
Design:
Survey.
Methods:
The Beck Depression Inventory and Cardiac Depression Scale were administered to 120 men at hospital discharge, as well as six, 12 and 36 weeks postoperatively. Cronbach's alpha scores were calculated for the measures at each point. Changes in scores over time were analysed using repeated measures analysis of variance. Associations between the measures scores were calculated using Pearson product-moment correlations. Agreement between the measures' dichotomised scores (depression/no depression) was examined using Cohen's Kappa statistic.
Results:
Internal consistency was similar for the Beck Depression Inventory (0.793-0.904) and Cardiac Depression Scale (0.859-0.910). Depression scores decreased over time with the Beck Depression Inventory [F(2.50, 175.29) = 22.27, p < 0.001] and Cardiac Depression Scale [F(2.68, 190.37) = 13.18, p < 0.001]. The measures had similar power [Cohen's f = 0.65 (Beck Depression Inventory) and 0.43 (Cardiac Depression Scale)] to reveal changes over time. The continuous scores were highly correlated at each point [0.737 (p < 0.001)-0.819 (p < 0.001)]. However, when dichotomised scores were compared, the chance corrected level of agreement was less impressive [0.198 (p = 0.014)-0.381 (p < 0.001)].
Conclusions:
The Cardiac Depression Scale may have utility for use with surgical cardiac patients. However, continued examination of this measure of depression is warranted.
Relevance To Clinical Practice:
Given the prevalence of depression and its negative impact on coronary artery disease, it is important to identify even mild depression in cardiac patients. Using a measure of depression specifically for cardiac patients, rather than a generic measure, may best accomplish this goal.
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