Anxiety and self-care behaviour in patients with chronic systolic heart failure: a multivariate model
Abstract
Background: While comprehensive evidence exists regarding negative effects of depression on self-care behaviours in patients with chronic heart failure (CHF), the relation between anxiety and self-care behaviours in patients with CHF is not clear. The aim of this study was to analyse the interactions between anxiety, depression and self-care behaviours in patients with CHF. Methods: The self-care behaviour of CHF outpatients was measured using the European Heart Failure Self-care Behaviour Scale (EHFScBS). The Patient Health Questionnaire (PHQ) was used to assess anxiety, the PHQ-9 was used to measure depression severity. Differences between patients with and without anxiety were assessed with the respective tests. Associations between anxiety, self-care and other predictors were analysed using linear regressions. Results: Of the 308 participating patients, 35 (11.4%) fulfilled the PHQ criteria for an anxiety disorder. These patients took antidepressants more frequently (11.8% versus 2.3%, p = .02), had had more contacts with their general practitioner within the last year (11.8 ± 16.1 versus 6.7 ± 8.6, p = .02), and had a higher PHQ-9 depression score (12.9 ± 5.7 versus 6.5 ± 4.7, p < .01) than patients without anxiety disorder. Anxiety and self-care were negatively associated (ß = −0.144, r2 = 0.021, p = 0.015). The explanation of variance was augmented in a multivariate regression with the predictors age, sex, education, living with a partner, and New York Heart Association (NYHA) class ( r2 = 0.098) when anxiety was added ( r2 = 0.112). Depression further increased the explanation of variance (ß = −0.161, r2 = 0.131, p = 0.019). Conclusions: Anxiety is negatively associated with self-care behaviour in patients with CHF. However, this effect disappears behind the stronger influence of depression on self-care. The consideration of mental comorbidities in patients with CHF is important.
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Anxiety in CVD is associated with poorer quality of life, poorer performance of self-care, and drop-out from cardiac rehabilitation.
“it is associated with poorer quality of life, 10-12 poorer performance of self-care 13 and drop-out from cardiac rehabilitation, 11”
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“…between anxiety and adverse outcomes in CVD is conflicting, it is associated with poorer quality of life, 10–12 poorer performance of self-care 13 and drop-out from cardiac rehabilitation, 11 and may, therefore, motivate managing anxiety in CVD. Cardiac rehabilitation does not necessarily…”
Background
- Authors
- Müller-Tasch, T., Löwe, B., Lossnitzer, N., Frankenstein, L., Täger, T., Haass, M., Katus, H., Schultz, J.-H., & Herzog, W.
- Affiliations
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum am Weissenhof, Germany
- Schön Klinik Hamburg Eilbek (DE)
- Heidelberg University (DE)
- Department of Cardiology, Theresien Hospital Mannheim, Mannheim, Germany
- Venue
- European Journal of Cardiovascular Nursing
- Publisher
- Oxford University Press (OUP)
- Published
- 2017-07-18
- Volume
- 17
- Issue
- 2
- Pages
- 170-177
- ISSN
- 1474-5151 (ISSN-L)
- 1873-1953
- OpenAlex
- W2737923516
- Cited by
- 64
- References
- 47
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 6 · 2023: 7 · 2022: 13 · 2021: 7 · 2020: 11 · 2019: 11 · 2018: 4 · 2017: 1
- FWCI
- 5.78
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- European Journal of Cardiovascular Nursing (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- anxiety, depression, self-care behavior, chronic systolic heart failure, psychiatric comorbidity, antidepressant use, NYHA functional class, European Heart Failure Self-care Behaviour Scale, Patient Health Questionnaire
- MeSH terms
- Adult, Aged, Anxiety Disorders, Chronic Disease, Depressive Disorder, Female, Humans, Male, Middle Aged, Self Care, Health Behavior, Comorbidity, Linear Models, Heart Failure, Systolic
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