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      Factors associated with depression among heart failure patients at selected public hospitals in Addis Ababa, Ethiopia: A cross sectional study

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          Abstract

          This study aimed to Assess Factors associated with depression among heart failure patients at cardiac follow-up clinics in a government teaching hospital of Addis Ababa. A cross-sectional study design was employed to assess Factors associated with depression among 424 heart failure patients at selected public hospitals of Addis Ababa who were selected by using a systematic random sampling method from January 1 to 30, 2021 at four public hospitals. Sample was proportionally allocated for each study hospital and then data were collected by using structured-interview questionnaires. Bivariate and Multivariate logistic regression analysis was done to examine the possible predictors and variables with the statistical association of P-value of < 0.05 and a 95% confidence interval were considered. Data were gathered from heart failure patients in cardiac follow clinic with 100% response rate. Among the 424 respondents [mean age: 52.7 (SD) 17.5 years; 56.1% women], prevalence of depression was 56.1%. Among the 424 respondents [mean age: 52.7 (SD) 17.5 years; 56.1% women], prevalence of depression was 56.1%. New York Heart Association class III and IV was highly associated with depression respectively. Furthermore, poor self-care behaviours alcohol use, poor social support, poor knowledge level, were associated with depression and statistically significant. The findings from this study showed that depression is highly prevalent among heart failure patients and age of respondent, alcohol intake, self-care behaviour, social support, knowledge level, and co-morbidity were independently associated with depression. Therefore, all institutions of cardiac centre should work on screening for depression in heart failure patients, and consult psychiatrists and psychologists for early detection and measures.

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          Most cited references36

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          The PHQ-9: validity of a brief depression severity measure.

          While considerable attention has focused on improving the detection of depression, assessment of severity is also important in guiding treatment decisions. Therefore, we examined the validity of a brief, new measure of depression severity. The Patient Health Questionnaire (PHQ) is a self-administered version of the PRIME-MD diagnostic instrument for common mental disorders. The PHQ-9 is the depression module, which scores each of the 9 DSM-IV criteria as "0" (not at all) to "3" (nearly every day). The PHQ-9 was completed by 6,000 patients in 8 primary care clinics and 7 obstetrics-gynecology clinics. Construct validity was assessed using the 20-item Short-Form General Health Survey, self-reported sick days and clinic visits, and symptom-related difficulty. Criterion validity was assessed against an independent structured mental health professional (MHP) interview in a sample of 580 patients. As PHQ-9 depression severity increased, there was a substantial decrease in functional status on all 6 SF-20 subscales. Also, symptom-related difficulty, sick days, and health care utilization increased. Using the MHP reinterview as the criterion standard, a PHQ-9 score > or =10 had a sensitivity of 88% and a specificity of 88% for major depression. PHQ-9 scores of 5, 10, 15, and 20 represented mild, moderate, moderately severe, and severe depression, respectively. Results were similar in the primary care and obstetrics-gynecology samples. In addition to making criteria-based diagnoses of depressive disorders, the PHQ-9 is also a reliable and valid measure of depression severity. These characteristics plus its brevity make the PHQ-9 a useful clinical and research tool.
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            The PHQ-9

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              Depression in heart failure a meta-analytic review of prevalence, intervention effects, and associations with clinical outcomes.

              This article describes a meta-analysis of published associations between depression and heart failure (HF) in regard to 3 questions: 1) What is the prevalence of depression among patients with HF? 2) What is the magnitude of the relationship between depression and clinical outcomes in the HF population? 3) What is the evidence for treatment effectiveness in reducing depression in HF patients? Key word searches of the Medline and PsycInfo databases, as well as reference searches in published HF and depression articles, identified 36 publications meeting our criteria. Clinically significant depression was present in 21.5% of HF patients, and varied by the use of questionnaires versus diagnostic interview (33.6% and 19.3%, respectively) and New York Heart Association-defined HF severity (11% in class I vs. 42% in class IV), among other factors. Combined results suggested higher rates of death and secondary events (risk ratio = 2.1, 95% confidence interval 1.7 to 2.6), trends toward increased health care use, and higher rates of hospitalization and emergency room visits among depressed patients. Treatment studies generally relied on small samples, but also suggested depression symptom reductions from a variety of interventions. In sum, clinically significant depression is present in at least 1 in 5 patients with HF; however, depression rates can be much higher among patients screened with questionnaires or with more advanced HF. The relationship between depression and poorer HF outcomes is consistent and strong across multiple end points. These findings reinforce the importance of psychosocial research in HF populations and identify a number of areas for future study.
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                Author and article information

                Contributors
                Role: Formal analysisRole: InvestigationRole: MethodologyRole: Project administrationRole: Writing – original draft
                Role: ConceptualizationRole: Data curationRole: SoftwareRole: SupervisionRole: Validation
                Role: ConceptualizationRole: Data curationRole: Project administrationRole: SupervisionRole: ValidationRole: VisualizationRole: Writing – review & editing
                Role: Editor
                Journal
                PLOS Glob Public Health
                PLOS Glob Public Health
                plos
                PLOS Global Public Health
                Public Library of Science (San Francisco, CA USA )
                2767-3375
                4 August 2022
                2022
                : 2
                : 8
                : e0000853
                Affiliations
                [001] School of Nursing and Midwifery, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
                Royal Infirmary of Edinburgh and University of Edinburgh, UNITED KINGDOM
                Author notes

                The authors have declared that no competing interests exist.

                Author information
                https://orcid.org/0000-0001-9737-9560
                Article
                PGPH-D-22-00002
                10.1371/journal.pgph.0000853
                10021377
                36962589
                440d265e-1ec4-4341-9cd6-1fa655508fc1
                © 2022 Alemayehu et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 15 January 2022
                : 9 July 2022
                Page count
                Figures: 3, Tables: 3, Pages: 15
                Funding
                The authors received no specific funding for this work.
                Categories
                Research Article
                Medicine and Health Sciences
                Cardiology
                Heart Failure
                Medicine and Health Sciences
                Mental Health and Psychiatry
                Mood Disorders
                Depression
                Medicine and Health Sciences
                Health Care
                Patients
                Biology and Life Sciences
                Nutrition
                Diet
                Alcohol Consumption
                Medicine and Health Sciences
                Nutrition
                Diet
                Alcohol Consumption
                Medicine and Health Sciences
                Epidemiology
                Medical Risk Factors
                People and Places
                Geographical Locations
                Africa
                Ethiopia
                Biology and Life Sciences
                Psychology
                Behavior
                Social Sciences
                Psychology
                Behavior
                Research and Analysis Methods
                Research Design
                Survey Research
                Questionnaires
                Custom metadata
                All relevant data are included within the manuscript document.

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