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Association of heart attack or stroke history with current mental health symptoms among adults in the USA: cross-sectional analyses of nationally representative samples

Por: Zhang · X. · Wang · Y. · Lee · J. S. · Pollack · L. M. · Luo · F.
Objectives

This study uses nationally representative survey data from the USA to estimate the relationship between a history of heart attack or stroke with the prevalence of mental health symptoms.

Design

Cross-sectional.

Setting

Data from the 2019 and the 2018 National Health Interview Survey (NHIS) sample adult interview.

Participants

30 872 adults from the 2019 NHIS and 24 593 adults from the 2018 NHIS were analysed separately; a history of heart attack or stroke was determined based on participants’ recollection of previous communications with health professionals.

Primary outcome measures

Poisson log-linear regressions with robust SEs were employed to estimate the relative prevalence of mental health symptoms associated with a history of heart attack or stroke. Mental health outcomes included moderate-to-severe depression symptoms according to the Patient Health Questionnaire, moderate-to-severe anxiety symptoms according to the General Anxiety Disorder scale and serious psychological distress according to the Kessler Psychological Distress scale.

Results

The prevalence of moderate-to-severe symptoms of depression, anxiety and serious psychological distress was more than two times as high among individuals with a history of heart attack or stroke compared with those without such a history. After adjusting for potentially confounding socio-demographic and health variables, survivors of heart attack were 33% and 40% more likely and survivors of stroke were 59% and 52% more likely to experience depression and anxiety symptoms, compared with adults without these conditions. Additionally, survivors of stroke were 76% more likely to have serious psychological distress than those without a stroke history.

Conclusion

Findings from this study highlight the increased mental health problems experienced by heart attack or stroke survivors relative to adults without these conditions. They underscore the importance of addressing mental health concerns among adults who have experienced a heart attack or stroke.

Patient Experiences of Receiving Stroke Discharge Information in Accordance With Preferences

ABSTRACT

Aims

To examine survivors' experiences of discharge information including risk communication after hospitalisation for a stroke and the characteristics associated with receiving information in accordance with their preferences.

Background

With advances in acute stroke care and an ageing population, the number of survivors of stroke is increasing. It is important that healthcare providers ensure patients have adequate information after a stroke-related hospitalisation.

Design

Cross-sectional study.

Methods

Adults recently discharged after a stroke from eight Australian hospitals were mailed a survey. Items examined risk and discharge care information, with participants asked to indicate both their preferences for and receipt of the information. Concordance with preferences was calculated, and characteristics associated with information preference concordance were assessed with binomial logistic regression. Study reported in accordance with STROBE Checklist.

Results

Of 1161 eligible patients invited, 403 (35%) completed the survey. All items were endorsed by 80% or more of respondents as being wanted. However, for all items, fewer respondents reported the care as received. Only 28% of participants received information on all five items according to their preferences. Hospital site, Body Mass Index and age were statistically significantly associated with participants receiving information in accordance with their preferences.

Conclusion

Most participants indicated a preference to receive recommended discharge information. Findings suggest that patients may benefit from increased information provision prior to hospital discharge after stroke.

Relevance to Clinical Practice and Patient Care

Nurses have an important role in the provision of stroke care and information. The findings of this study may be used to improve the provision of post-hospital discharge care and support for survivors of stroke, and assist in identifying patients at lower odds of experiencing information aligned with their preferences and who may benefit from support.

Reporting Method

Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist for cross-sectional studies.

Patient or Public Contribution

No patient or public contribution.

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