Depressive Symptoms and Perceptions of ED Care in Patients Evaluated for Acute Coronary Syndrome.
Tara St Onge, Donald Edmondson, Emily Cea and 2 others
PMID 28527642WHAT IT FOUND
Patients with depressive symptoms being evaluated for acute coronary syndrome perceived the emergency department as more stressful, even when measured crowding was the same.
Higher crowding was linked to higher perceived stress most strongly in patients with depressive symptoms.
Key findings
01Objective emergency department crowding scores were the same for patients with and without depressive symptoms, at 1.37 in both groups.
02Patients with depressive symptoms perceived the emergency department as more stressful, 2.8 versus 2.4, and reported a longer stay, 19.5 versus 18.5 hours, and a longer wait for a care plan, 9.5 versus 7.8 hours.
03Higher objective crowding was linked to higher perceived stress for all patients, but the link was stronger among patients with depressive symptoms.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was done in one urban academic emergency department, so findings may not generalise to other patient populations. Stress, crowding perception, length of stay, and wait time were self-reported. Patients with ST elevation on electrocardiogram, inability to comply, immediate psychiatric need, or expected unavailability were excluded. The study was observational, so it cannot show that depression caused more negative perceptions or that crowding caused stress. The study did not test interventions or later outcomes such as posttraumatic stress disorder, recurrent acute coronary syndrome, or mortality.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not conclude that depression caused patients to perceive the emergency department as more stressful, or that reducing crowding or providing bedside support will improve outcomes. This was an observational study of perceptions during one emergency department visit, not a test of interventions or later cardiovascular or psychological outcomes.