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Published on: December 2, 2015
Predictors of depressive symptoms in older veterans with heart failure
Amber Lynn Paukert1, Ashley LeMaire, Jeffrey A Cully
1Affairs Puget Sound Health Care System, Seattle, WA, USA. Amber.Paukert@VA.gov
Insights
Depressive symptoms in older veterans with heart failure (HF) are reduced by decreasing perceptions of HF intrusiveness and attributing locus of control to chance, even with physical limitations. These cognitive factors are key for depression treatment.
Area of Science:
- Gerontology
- Cardiology
- Psychiatry
Background:
- Heart failure (HF) significantly impacts older adults, often co-occurring with depression.
- Understanding factors predicting depression in this population is crucial for effective management.
Purpose of the Study:
- To identify key predictors of depressive symptoms in older veterans with HF.
- To determine the relative importance of demographic factors, physical limitations, illness perceptions, coping, locus of control, self-efficacy, and social support.
Main Methods:
- 104 older veterans with HF were assessed.
- Participants were screened for depression and anxiety, with equal numbers of anxious/depressed and non-anxious/non-depressed individuals.
- Validated scales measured HF limitations, illness intrusiveness, coping, locus of control, self-efficacy, and social support.
Main Results:
- Depressive symptoms were correlated with HF physical limitations, illness intrusiveness, maladaptive coping, chance locus of control, and low self-efficacy.
- Perceptions of HF intrusiveness and attributing locus of control to chance independently predicted depressive symptoms.
Conclusions:
- Reducing perceptions of HF intrusiveness and shifting locus of control away from chance can decrease depressive symptoms in older HF patients.
- These cognitive and perceptual factors are important targets for depression treatment in this demographic.
Objectives:
This study collected data on demographic factors, heart failure physical limitations, perception of heart failure intrusiveness, coping mechanisms, locus of control, self-efficacy and social support for 104 older veterans with heart failure (HF) to determine the factors' relative importance in predicting depressive symptoms.
Method:
Participants were veterans at least 60 years of age with HF who were screened for depression and anxiety with the Geriatric Depression Scale and Geriatric Anxiety Inventory, respectively, so that the final sample consisted of equal numbers with and without significant levels of anxiety and depression. Other measures included the Kansas City Cardiomyopathy Questionnaire, Heart Failure Illness Intrusiveness Rating Scale, Brief-COPE, Multidimensional Health Locus of Control Scale, Chronic Disease Self-Efficacy and Multidimensional Scale of Perceived Social Support.
Results:
Correlational analyses indicated that depressive symptoms were significantly associated with physical limitations from HF, HF perceptions of intrusiveness, maladaptive coping, attributing locus of control to chance and HF self-efficacy. Including these variables in one regression equation predicting depressive symptoms indicated that perceptions of intrusiveness from HF and attributing locus of control to chance were the only variables to predict depressive symptoms independent of the influence of other significant bivariate predictors.
Conclusion:
Even if physical limitations, maladaptive coping and self-efficacy are held constant, decreasing perceptions of HF intrusiveness and locus of control to chance reduce depressive symptoms. These two cognitive/perceptual factors may play a salient role in treatment of depression among older HF patients.
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