Introduction: A cardiac pacemaker is a small implanted device to control abnormal heart rhythms. According to estimates, 3 million individuals worldwide live with an implanted permanent pacemaker (PPM) while about 600 thousand pacemakers are implanted, annually.Purpose: to explore anxiety of pacemaker recipients as well as all the associated demographic and self-reported characteristics.Material and Method: 100 outpatients with PPM were enrolled in the study. Collection of data was performed by the completion of the “Self-rating Anxiety Scale Zung (SAS)” which included patients' characteristics. Results: From the 100 participants 65% were men, 66% were >70 years old, 60% married, 50,5% of primary education and 90% lived in Attica. In terms of anxiety, 50% of recipients scored less than 48 on SAS scale (wide of range: 20-80) indicating mild to low levels of anxiety. Regarding associated factors, anxiety was found to be statistically significantly associated with gender (p=<0,001), understanding of provided information (p=<0,001), understanding of precautions in electromagnetic fields (p=0,021), desire for more frequent and long term follow-up and devise assessment (p=<0,001 and p=<0,001, respectively).Conclusions: Though pacemaker is an opportunity to prolong survival, however systematic assessment of anxiety and all the associated factors is considered to be of primary importance in clinical pacemaker settings.
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Introduction: Depression is a commonly experienced psychological disorder among patients undergoing hemodialysis and has a strong association with insomnia and fatigue. The purpose of the present study was to explore the factors related to depression in dialysis patients and the impact of insomnia and fatigue on depression. Methods: In this cross-sectional study, one hundred (n=100) patients on hemodialysis from one hemodialysis center in Greece participated. Data collection was carried out by interviews using the Zung Self-rating Depression Scale (SDS) for the evaluation of depression; the Athens Insomnia Scale (AIS) for the evaluation of insomnia; the Modified Fatigue Impact Scale (MFIS) for the evaluation of fatigue; and a questionnaire which was created by the researchers. The Kruskal-Wallis, the Mann-Whitney tests, and the Spearman's rho criterion were used to evaluate the relationship between depression score and patient characteristics. Multiple linear regression was performed to assess the effect of characteristics on patients' depression. Results: Statistically significantly high levels of depression were found in patients over the age of 70 years old (p=0.001), in divorced/widowed patients (p = 0.001), in pensioners (p = 0.002), in patients who had other diseases (p = 0.001), in those who felt tired after hemodialysis or at night and those who felt constantly tired (p = 0.001, p = 0.016, and p = 0.001, respectively), in those who had physical and mental fatigue (p = 0.001 and p = 0.001, respectively), in those who had changes in body image (p = 0.009), itching, stiffness, and nausea/vomiting (p = 0.001, p = 0.001, and p = 0.003, respectively), in patients who had restrictions in clothes they could wear (p = 0.001), in patients who had insomnia (p = 0.001), and in patients who did not wish to receive written information about the management of their disease (p = 0.025). A statistically significant positive linear association was detected between physical/mental fatigue and depression levels (rho = 0.824 and rho = 0.746, respectively) and between the score of insomnia and depression levels (rho = 0.707). An increase in fatigue (either physical or mental) and an increase in insomnia score also indicated an increase in depression levels. Conclusions: The findings of this study showed that depression had a strong association with a variety of demographic factors. Additionally, an increase in fatigue score and an increase in insomnia score indicated an increase in depression levels. Therefore, depression, insomnia, and fatigue should be early assessed and effectively treated by renal professionals in order to improve the quality of life in hemodialysis patients and reduce their morbidity and mortality.
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