Depressive symptoms in women being screened for cardiovascular disease risk.

摘要

This study investigated the relationship between depressive symptoms, health-promoting lifestyle behaviors, heart disease risk awareness, cardiac risk, and quality of life in women. Whether the effect of depressive symptoms on quality of life was mediated by cardiac risk and/or health-promoting lifestyle behaviors was also examined, and is a unique contribution of this study.Study participants were predominantly urban, non-Hispanic, white, married, with some college education, employed full-time, and a household income between Depressive symptoms were not associated with cardiac risk or with risk awareness. Since these were generally "risk aware women", it is not surprising that depressive symptoms were not associated with risk awareness. In addition, due to the fact that most of the depressed women were in the "at risk and high risk" groups, it may have been difficult to detect a significant relationship between depressive symptoms and risk status. However, depressive symptoms were inversely associated with health-promoting lifestyle behaviors (rS = -.37, p .01) and quality of life (rS = -.51, p .01). Furthermore, depressive symptoms had a dose-response relationship with health-promoting lifestyle behaviors (OR = .92, 95% CI .88, .97, p .001) and quality of life (OR = .85, 95% CI .79, .92, p .001). The higher the depressive symptoms score, the less likely were the women to follow health-promoting lifestyle behaviors and the less likely were they to report a good quality of life. Health-promoting lifestyle behaviors (b = 2.20, SE .83, t = 2.65, p .01) but not cardiac risk mediated the effect of depressive symptoms on quality of life.An inverse and dose-response relationship was found between depressive symptoms, health-promoting lifestyle behaviors, and quality of life. Since no relationship was found between depressive symptoms and cardiac risk, it was eliminated as a possible mediator. Health-promoting lifestyle behaviors were found to mediate the relationship between depressive symptoms and quality of life in these women being screened for cardiovascular disease risk.Since nurses most often manage cardiovascular disease risk screening programs, it is important for them to understand the impact that depressive symptoms have on health-promoting lifestyle behaviors and quality of life. The results of this study indicate that screening for depressive symptoms is important for cardiovascular disease risk assessments. It is recommended that education and implementation of depression assessment be incorporated into cardiovascular risk screening events. Finally, the inverse dose-response relationship between depressive symptoms and adherence to treatment plans should be an important consideration when designing risk reduction interventions for patients in the future. (Abstract shortened by UMI.)