Assessment of Cardiovascular Disease-Related Distress and Psychosocial Determinants: A Prospective Observational Study.

Abstract

Introduction: Acute Coronary Syndrome (ACS) imposes substantial psychological and cardiovascular disease-related distress, influenced by socioeconomic and psychosocial determinants. Identifying these determinants is essential for improving patient outcomes and delivering holistic patient-centered care.

Objectives: This study aimed to assess cardiovascular disease-related distress among patients with Acute Coronary Syndrome (ACS) and examine its association with psychosocial and socioeconomic determinants.

Methodology: A prospective observational study was conducted over five months at a tertiary care hospital after obtaining ethical approval. A total of 105 adult patients diagnosed with ACS by a cardiologist were enrolled. Patients aged ≥ 18 years, of either gender, who provided written informed consent were included in the study. Socio-demographic characteristics, clinical parameters, and cardiovascular disease-related distress were assessed using a structured distress assessment tool comprising domains including Fear and Uncertainty, Changes to Role and Responsibilities, Economic Impact, and Overwhelm and Depletion. Data regarding psychosocial and socioeconomic determinants were collected and analyzed to evaluate their association with distress levels.

Results: The highest distress scores were observed in the domains of changes in roles and relationships, overwhelm and depletion, and fear and uncertainty. Significant associations were identified between cardiovascular distress and socioeconomic status, age, gender, and polypharmacy (p < 0.05). Patients from lower socioeconomic classes and rural areas demonstrated higher psychosocial and economic distress, while female participants reported significantly greater distress in role-related and medication-management domains. No significant association was observed between distress and ACS subtype or comorbidity burden.

Conclusion: Cardiovascular disease-related distress among ACS patients varied across specific psychosocial domains rather than uniformly affecting all aspects of patient well-being. Distinct patterns of distress were observed across socioeconomic groups, highlighting the influence of psychosocial and socioeconomic determinants on cardiovascular distress. These findings emphasize the importance of identifying domain-specific distress to facilitate targeted and individualized patient care.