A new study suggests that a perceived sense of control dramatically influences cardiac outcomes.
Researchers discovered patients admitted to a hospital with obstructed heart arteries were three times more likely to experience complications when they were in hospital if they felt they were not in control of their condition.
Anxiety, however, did not appear to be a factor for whether patients experienced complications or not.
In the study, researchers followed the care of 171 patients admitted to hospitals in the United States, Australia and New Zealand with acute coronary syndrome (ACS) for a period of two years. Approximately two-thirds of the patients were male, with an average age of 69 years.
Acute coronary syndrome is a serious cardiac condition usually associated with a blood clot or plaque that obstructs blood from part of the heart.
“Coronary heart disease is the leading single cause of death in Australia and the USA, accounting for almost one in five deaths and leading to 50,000 hospital admissions a year in Australia and 1.76 million a year in the USA,” said lead author Sharon McKinley, Ph.D.
The study is published in the Journal of Advanced Nursing.
During the study research team members spoke to all the participants at three, 12 and 24 months and gave them a free telephone number to call if they were admitted to a hospital for suspected ACS symptoms.
Patient records were then examined by experienced cardiovascular nurses documenting and abstracting individuals’ particular clinical characteristics and complications.
The anxiety and perceived control measures were ascertained in face-to-face interviews when patients were enrolled in the study and by mailed questionnaires with follow-up telephone interviews at three and 12 months.
Key findings included:
- Fifteen percent of the patients experienced complications when they were in hospital following admission for ACS, mainly due to an abnormal heart beat or reduced blood supply to the heart;
- Half of the patients studied were anxious at baseline and 56 percent at three months. Over a third of patients (37 percent) displayed anxiety at both points and were categorised as persistently anxious;
- 58 percent of patients had low perceived control and these patients tended to be younger, have a higher body mass index and a higher pulse rate on admission;
- 73 percent of the patients with persistent anxiety had low perceived control and the remaining 27 percent had high perceived control;
- Patients with low perceived control over their heart conditions were 3.4 times as likely to experience in-hospital complications as patients with high levels of control.
“The findings that low perceived control, but not persistent anxiety, were predictive of in-hospital complications after ACS has two key implications for nursing practice and policy” said McKinley.
“Firstly, it may be possible for nurses to increase cardiac patients’ perception of control over their illness and secondly, increasing perceived control may reduce the risk of complications after ACS.”