Comparison of the Short Form 36 and the Hospital Anxiety and Depression Scale measuring emotional distress in patients admitted for elective coronary angiography
Background
Anxiety and depression are frequently observed in patients with coronary artery disease. Because emotional distress is of prognostic importance in these patients, screening is recommended.
Objective
We compared the Short Form 36 (SF-36) and the Hospital Anxiety and Depression Scale (HADS) in measuring emotional distress in patients admitted for elective coronary angiography.
Methods
A total of 587 patients were consecutively included (mean age 62 years, 75% were male). Gender-specific partial correlations were calculated for the associations between their SF-36 and HADS scores, whereas subgroup differences were evaluated using t tests or analysis of variance.
Results
In both genders, the HADS subscales for anxiety and depression were significantly related to all SF-36 subscales and most strongly related to the Mental Health subscale. Both HADS and the Mental Health subscale demonstrated a high occurrence of emotional distress and discriminated significantly between patients with and without severe angina. The HADS, but not the SF-36, demonstrated high levels of emotional distress (anxiety) among men without verified coronary artery disease.
Conclusion
Both instruments seem appropriate as screening instruments for emotional distress in patients with suspected coronary artery disease. Although the Mental Health subscale has the advantage of being shorter, we recommend the HADS because it shows anxiety more specifically.
aBergen University College Faculty of Health and Social Sciences, Bergen, Norway
bDepartment of Child and Adolescent Mental Health Services, Haukeland University Hospital, Bergen, Norway
cDepartment of Public Health and Primary Health Care, University of Bergen, Norway
dCentre for Clinical Research, Haukeland University Hospital, Bergen, Norway
eInstitute of Medicine, University of Bergen, Norway
fDepartment of Heart Disease, Haukeland University Hospital, Bergen, Norway.
Corresponding author: Bjørg Ulvik, MSc, RN, Bergen University College, Faculty of Health and Social Sciences, Haukelandsbakken 45, N-5009 Bergen, Norway.
This project was aided by EXTRA funds from the Norwegian Foundation for Health and Rehabilitation, the Norwegian Nurses Association, and the Vesta Insurance Company.
ABSTRACT