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DO SOCIAL ISOLATION AND DEPRESSION AFFECT RATES OF HOSPITAL READMISSION FOR PATIENTS WITH HEART FAILURE?

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Please use this identifier to cite or link to this item: http://hdl.handle.net/1928/11122

DO SOCIAL ISOLATION AND DEPRESSION AFFECT RATES OF HOSPITAL READMISSION FOR PATIENTS WITH HEART FAILURE?

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Title: DO SOCIAL ISOLATION AND DEPRESSION AFFECT RATES OF HOSPITAL READMISSION FOR PATIENTS WITH HEART FAILURE?
Author: Samaniego, Irma
Advisor(s): Parshall, Mark
Committee Member(s): Escandon, Socorro
Brooks, Annette
Schuster, Geoff
Stidley, Christine
Department: University of New Mexico. College of Nursing
Subject(s): social isolation
depression
Degree Level: Doctoral
Abstract: Heart failure (HF) is a syndrome that primarily affects the aged and is the most common hospital discharge diagnosis for adults in the United States. Readmission is common following discharge from an acute hospital stay for HF. Patients with HF suffer more depressive morbidity than other patients with cardiovascular disease, and many age 65 or older experience social isolation. This prospective exploratory study examined whether readmission within 30 to 60 days of discharge from an index hospitalization for HF was associated with depressive symptoms or social isolation. A convenience sample of 101 patients participated during an index hospitalization for HF. Participants were followed-up for any readmissions within 30 or 60 days of discharge. Depressive symptoms were measured with the 15-item Geriatric Depression Scale (GDS-15) and social isolation with the Lubben Social Network Scale (LSNS). At least one readmission for HF occurred for 27 participants within 30 days and for 31 within 60 days. Cronbach’s alpha for the GDS-15 was extremely low (.39), and few participants (n = 9) had scores consistent with risk for depression; hence, GDS-15 scores were inadequate for testing any association with readmission. The LSNS was reliable (alpha = .77), and 13 participants (13%) had scores consistent with social isolation. There was no association between social isolation and readmission within 30 or 60 days. However, responses to the LSNS helped to identify several patients whose need for social services had not been identified by hospital staff. In exploratory analyses, b-type natriuretic peptide (BNP) within 24 hours of the index admission was associated with readmission, median = 3327 vs. 852 pg/ml, p=.056, and 3782 vs. 845 pg ml, p=.016 for any vs. no readmission within 30 or 60 days, respectively. Limitations include convenience sampling and possible sampling bias as well as a relatively brief follow-up period. Despite the lack of association with readmission, there may be other reasons for screening patients hospitalized for HF for depression or social isolation. The association between BNP and readmission merits further investigation in a study designed for that purpose.
Graduation Date: July 2010
URI: http://hdl.handle.net/1928/11122

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