Journal of Cardiac Failure
Volume 15, Issue 7 , Pages 572-579, September 2009

Anxiety and Depression in Ethnic Minorities With Chronic Heart Failure

  • Lorraine S. Evangelista, RN, PhD

      Affiliations

    • School of Nursing, UCLA, Los Angeles, CA
    • Corresponding Author InformationReprint requests: Lorraine S. Evangelista, RN, PhD, School of Nursing, University of California, Los Angeles, 700 Tiverton Ave, Factor 4-258, Los Angeles, CA 90095-6918. Tel: (310) 825-8609; Fax: (310) 794-7482.
    • ,
  • Alvina Ter-Galstanyan, MPh

      Affiliations

    • School of Public Health, UCLA, Los Angeles, CA
    • ,
  • Samira Moughrabi, RN, PhD

      Affiliations

    • School of Nursing, UCLA, Los Angeles, CA
    • ,
  • Debra K. Moser, RN, DNSc

      Affiliations

    • School of Nursing, University of Kentucky, Lexington, Kentucky

Received 2 February 2009; received in revised form 9 March 2009; accepted 20 March 2009. published online 22 May 2009.

Abstract 

Background

Considerable evidence confirms the high prevalence of anxiety and depression in the patients with heart failure (HF). However, little is known about the relationship of race/ethnicity to psychosocial variables in this population. The purpose of this study was to examine and compare the incidence of anxiety and depression in a cohort of non-Hispanic blacks, Hispanics, and non-Hispanic whites with advanced systolic HF.

Methods and Results

Two-hundred forty-one patients (7% non-Hispanic blacks, 22.8% Hispanics, 60.7% non-Hispanic whites) mean age 56.7±13.0 years, male (70%), married (81%), retired (75%), New York Heart Association (NYHA) Class III (53.9%), and mean ejection fraction 31.2±5.4%) from a single heart transplant facility were asked to complete a series of questionnaires to assess anxiety, depression, perceived control, social support, and financial stability. Non-Hispanic blacks had higher levels of anxiety (P=.048) and depression (P=.026) compared with Hispanics; a similar trend was noted when comparing non-Hispanic blacks and non-Hispanic whites, but these differences were not statistically significant. Perceived control was highest among Hispanics and lowest among non-Hispanic whites (P=.046). In a multivariate model race/ethnicity, perceived control, and social support accounted for 30% of the variance in anxiety while race/ethnicity, NYHA Class, perceived control, and social support accounted for 41% of the variance in depression.

Conclusions

Our findings reveal that non-Hispanic blacks are more likely to be anxious and depressed than their counterparts. Because patient perceptions of control and social support are related to dysphorias known to influence morbidity and mortality, clinicians should regularly assess patients' concerns and assist in accessing appropriate services and treatments tailored to individual needs. Non-Hispanic blacks warrant increased scrutiny.

Key Words: Social support, financial stability, perceived control, confide

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 Funded by American Heart Association Western Division (NCR, 133-09, PI, K. Dracup) and the University of California School of Nursing Intramural Research Grant; supported, in part, by Center grant, 1P20NR010679 from NIH, National Institute of Nursing Research.

 Lorraine S. Evangelista received support from the University of California, Los Angeles, Resource Centers for Minority Aging Research/Center for Health Improvement of Minority Elderly (RCMAR/CHIME) under NIH/NIA Grant P30-AG02-1684, and does not necessarily represent the official views of the National Institute On Aging or the National Institutes of Health.

 The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Nursing Research or the National Institutes of Health.

PII: S1071-9164(09)00097-9

doi:10.1016/j.cardfail.2009.03.005

Journal of Cardiac Failure
Volume 15, Issue 7 , Pages 572-579, September 2009

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