Therapeutic effects of nurse-led telephone follow-up on depression, anxiety, and stress in cardiovascular disease patients: a randomized clinical trial
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Background
Depression and anxiety are common among patients with cardiovascular disease (CVD) and are associated with poorer clinical outcomes, including increased complications and recurrent events. Nurse-led telephone follow-up after discharge has shown benefits in patient support and symptom management; however, its impact on psychological outcomes remains unclear. Therefore, this study aimed to evaluate the effects of a nurse-led telephone follow-up program on depression, anxiety, and stress levels in patients with cardiovascular disease.
Methods
An experimental study was conducted with 60 randomly selected patients from the Coronary Care Unit (CCU) department of a hospital in Iran, who were divided into two groups: an intervention group and a control group. The educational intervention was administered within two weeks after discharge. Data were collected via the Depression Anxiety Stress Scale (DASS-21). Descriptive analysis, Mann-Whitney and Wilcoxon tests, Generalized Estimating Equations (GEE) regression, and Spearman’s correlation were used for data analysis.
Results
The mean age of the patients was 57.43 ± 15.33 years. No significant differences were observed between the intervention and control groups regarding depression, anxiety, or stress scores (p>0.05). However, depression and anxiety scores decreased over time in both groups, with mean reductions of 1.53 and 1.18 points, respectively. Furthermore, an increase in patients’ ejection fraction (EF) was associated with a 0.1-point decrease in both depression and anxiety levels. No significant association was found between stress and the studied variables.
Conclusions
Depression and anxiety decreased over time in patients with cardiovascular disease. However, no significant differences were found between the intervention and control groups. Improved cardiac function (ejection fraction) was associated with lower depression and anxiety, highlighting the importance of integrating psychological and clinical care. Further studies with larger samples and longer follow-up are recommended.
