Open AccessPosttraumatic stress disorder predicts poor health-related quality of life in cardiac patients in Palestine
Author(s) -
Hala Allabadi,
Abdulsalam Alkaiyat,
Tamer Zahdeh,
Alaa Assadi,
Aya Ghanayim,
Shaden Hasan,
Dalia Abu Al Haj,
Liana Al-Labadi,
Saleem HajYahia,
Christian Schindler,
Marek Kwiatkowski,
Elisabeth Zemp,
Nicole ProbstHensch
Publication year - 2021
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0255077
Subject(s) - anxiety , medicine , mental health , quality of life (healthcare) , psychological intervention , depression (economics) , psychiatry , population , cohort , cohort study , clinical psychology , environmental health , nursing , economics , macroeconomics
Background The longitudinal association of posttraumatic stress disorder (PTSD) with health-related quality of life (HRQL) in cardiac patients’ remains poorly studied, particularly in conflict-affected settings. Materials and methods For this cohort study, we used baseline and one-year follow-up data collected from patients 30 to 80 years old consecutively admitted with a cardiac diagnosis to four major hospitals in Nablus, Palestine. All subjects were screened for PTSD and HRQL using the PTSD Checklist Specific and the HeartQoL questionnaire. We used a generalized structural equation model (GSEM) to examine the independent predictive association of PTSD at baseline with HRQL at follow-up. We also examined the mediating roles of depression, anxiety, and stress at baseline. Results The prevalence of moderate-to-high PTSD symptoms among 1022 patients at baseline was 27∙0%. Patients with PTSD symptoms reported an approximate 20∙0% lower HRQL at follow-up. The PTSD and HRQL relationship was largely mediated by depressive and anxiety symptoms. It was not materially altered by adjustment for socio-demographic, clinical, and lifestyle factors. Discussion Our findings suggest that individuals with a combination of PTSD and depression, or anxiety are potentially faced with poor HRQL as a longer-term outcome of their cardiac disease. In Palestine, psychological disorders are often stigmatized; however, integration of mental health care with cardiac care may offer an entry door for addressing psychological problems in the population. Further studies need to assess the effective mental health interventions for improving quality of life in cardiac patients.