Objectives: The objectives of this study are to use CART (Classification and regression tree) and step-wise regression to 1) define the predictors of quality of life in ACS (acute coronary syndrome) patients, using demographics, ACS symptoms, and anxiety as independent variables; and 2) discuss and compare the results of these two statistical approaches. Back- ground: In outcome studies of ACS, CART is a good alternative approach to linear regression; however, CART is rarely used. Methods: A descriptive survey design was used with 100 samples recruited. Result and Conclusions: Anxiety is the most significant predictor and also a stronger predictor than symptoms of ACS for the quality of life. The anxiety level patients experienced at the time heart attack occurred can be used to predict quality of life a month later. Furthermore, the majority of ACS patients experienced a moderate to high level of anxiety during a heart attack.
Lloyd-Jones, D., Adams, R., Carnethon, M., et al. (2009) Heart Disease and Strok Statistic—2009 Update: A report from the American Heart Association statistics committee and stroke statistic. Circulation, 119, 21-181.
Shin, J.Y., Martin, R. and Suls, J. (2009) Meta-analytic evaluation of gender differences and symptom measurement strategies in acute coronary syndromes. Heart & Lung, 39, 283-295. doi:10.1016/j.hrtlng.2009.10.010
Koivula, M., Hautamaki-Lamminen, K. and Astedt-Kurki, P. (2009) Predictors of fear and anxiety nine years after coronary artery bypass grafting. Journal of Advanced Nursing, 66, 595-606.
Gudykunst, W.B. and Nishida, T. (2001) Anxiety, uncertainty, and perceived effectiveness of communication across relationships and cultures. International Journal of Intercultural Relations, 25, 55-71.
Wang, W., Chair, S.Y., Thompson, D.R., et al. (2009) A psychometric evaluation of the Chinese version of the Hospital Anxiety and Depression Scale in patients with coronary heart disease. Journal of Clinical Nursing, 18, 1908-1915. doi:10.1111/j.1365-2702.2008.02736.x
Karlsson, I., Berglin, E. and Larsson, P.A. (2000) Sense of coherence: Quality of life before and after coronary artery bypass surgery—A longitudinal study. Journal of Advanced Nursing, 30, 1383-1392.
Koivula, M., Tarkka, M.T., Tarkka, M., et al. (2002) Fear and anxiety in patients at different time-points in the coronary artery bypass process. International Journal of Nursing Studies, 39, 811-822.
Andrew, M.J., Baker, R.A., Kneebone, A.C., et al. (2000) Mood state as a predictor of neuropsychological deficits following cardiac surgery. Journal of Psychosomatic Research, 48, 537-546.
Tung, H.H., Hunter, A., Wei, J., et al. (2009) Gender differences in coping and anxiety in patients after coronary artery bypass graft surgery in Taiwan. Heart & Lung, 38, 469-479.
Chan, D.S.K., Chau, J.P.C. and Chang, A.M. (2005) Acute coronary syndromes cardiac rehabilitation programmers and quality of life. Journal of Advanced Nursing, 49, 591-599. doi:10.1111/j.1365-2648.2004.03334.x
Treat-Jacobson, D.J. and Lindquist, R. (2007) Exercise, quality of life, and symptoms in men and women five to six years after coronary artery bypass graft surgery. Heart & Lung, 36, 387-297. doi:10.1016/j.hrtlng.2007.01.002
Rantanen, A., Kaunonen, M., Sintonen, H., et al. (2008) Factors associated with health-related quality of life in patients and significant others one month after coronary artery bypass grafting. Journal of Clinical Nursing, 17, 1742-1753. doi:10.1111/j.1365-2702.2007.02195.x
Ulvik, B., Nygard, O., Hanestad, B.R., et al. (2008) Associated between disease severity, coping and dimensions of health-related quality of life in patients admitted for elective coronary angiography—A cross sectional study. Health and Quality of Life Outcomes, 6, 38.
Szekely, A., Balog, P., Benko, E., et al. (2007) Anxiety predicts mortality and morbidity after coronary artery and valve surgery—A 4-year follow-up study. Psychosomatic Medicine, 69, 625–631.
Benedetto, M.D., Lindner, H., Hare, D.L., et al. (2007) The role of coping, anxiety, and stress in depression post- acute coronary syndrome. Psychology, Health & Medicine, 12, 460-469. doi:10.1080/13548500601109334
Tully, P.J., Baker, R.A., Turnbull, D.A., et al. (2009) Negative emotion and quality of life six mouths after cardiac surgery: The dominant role of depression not anxiety symptoms. Journal of Behavioral Medicine, 32, 512-522.
Souza, R.C., Pinheiro, R.S., Coeli, C.M., et al. (2006) The Charlson comorbidity index (CCI) for adjustment of hip fracture mortality in the elderly: Analysis of the importance of recording econdary diagnoses. Cadernos de Saúde Pública, 24, 315-322.
McGregor, J.C., Kim, P.W., Perencevich, E.N., et al. (2005) Utility of the chronic disease score and charlson comorbidity index as comorbidity ceasures for use in epidemiologic studies of antibiotic-resistant organisms. American Journal of Epidemiology, 161, 483-493.
Seo, H.J., Yoon, S.J., Lee, S.I., et al. (2010) A comparison of the Charlson comorbidity index derived from medical records and claims data from patients undergoing lung cancer surgery in Korea: A population-based investigation. BMC Health Services Research, 10, 236.
McGregor, J.C., Kim, P.W., Perencevich, E.N., Bradham, D.D., Furuno, J.P., Kaye, K.S., et al. (2005) Utility of the chronic disease score and Charlson comorbidity index as comorbidity measures for use in epidemiologic studies of antibiotic-resistant organisms. American Journal of Epidemiology, 161, 483-493. doi:10.1093/aje/kwi068
Hoehn-Sark, R., McLeod, D., Funderburk, F., et al. (2004). Somatic symptoms and physiologic responses in generalized anxiety disorder and panic disorder. Archives of General Psychiatry, 61, 913-921.
Tung, H.H., Chen, Y.C., Wei, J., et al. (2010) Leisure physical activity and quality of life after coronary artery bypass graft surgery for patients with metabolic syndrome in Taiwan. Heart & Lung, 39, 410-420.