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Learning Objective 1: The learner will be able to identify the importance of screening anxiety and depression with COPD patients
Learning Objective 2: The learner will be able to learn more about the value of the Hospital Anxiety and Depression scale (HADS) as a nursing screening tool.
Depressive symptoms are common among patients with chronic obstructive pulmonary disease (COPD). Anxiety and depression has been associated with poorer health outcomes. Depressive symptoms in patients with COPD are associated with poorer survival, persistent smoking, increased symptom burden, longer hospital stay, and poorer physical an social functioning.
The lung department of the St Antonius Hospital has limited data available regarding the level of anxiety and depression with COPD patients during a hospital stay. Nurses could screen COPD patients during admission using the hospital anxiety and depression scale (HADS). But how big is the problem?
Method
The HADS is an easily administered, 14-item self-report measure comprising 7 anxiety items and 7 depression items from which separate anxiety and depression sub-scale scores are calculated.
Patients were included in this baseline study, provided that they had been admitted with acute exacerbations of obstructive lung disease during April 2010. An acute exacerbation was defined as a change in condition for a COPD patient from baseline of such a magnitude that it needed an acute hospital admission. Patients with asthma were excluded. All patients were part of a COPD Clinical Pathway during there hospital stay.
Results
The HADS scores indicated presence of anxiety and depression. Fifty-one patients completed the questionnaire. For depression 20% (n = 10) had a probability score for depression (a depression scale score of >11) and could be seen by a psychiatrist for diagnose and treatment.
Conclusions
The question whether patients admitted with a COPD exacerbation have an increased risk for depressive and /or anxiety have shown a highly relevant research question. Interventions that reduce depressive symptoms may potentially affect COPD outcomes. Screening for depression and anxiety is the first step. Nurses could play an important role by using the HADS for COPD patients at admission.