Evaluation of Death Anxiety and Demoralization in Patients with Acute Myocardial Infarction

Background and Aim: Due to the dangerous nature of cardiovascular diseases and their chronicity, these diseases are considered as a crisis in the life of the patient and in addition to physical problems, also severely affect the psychological state of patients. It is very important to pay attention to the psychological complications after a heart attack in line with other physiological complications. The proximity of these patients to death has caused death anxiety which can weaken their morale. The aim of this study was to determine death anxiety and demoralization in patients with acute myocardial infarction admitted to Post Cardiac care units of Iran University of Medical Sciences in 2021. Method: The present study is a descriptive cross-sectional study that was performed on 206 patients with myocardial infarction admitted to the educational-medical centers of Iran University of Medical Sciences in the first half of 2021. Inclusion criteria include: definitive diagnosis of acute myocardial infarction, no death of first-degree relatives in the last 6 months, no alcohol and drug addiction according to the patient's report, no surgery in the last 6 months, having stable vital signs and stable condition Was cardiac hemodynamics. Exclusion criteria were incomplete completion of questionnaires. Data collection tools included demographic profile form, Templer death anxiety questionnaire, and Kissane demoralization. Sampling was continuous and myocardial infarction patients who were on the same day discharge list were selected and completed the questionnaires. Due to the sensitivity of the issue, people who had high anxiety and low mood based on the cutting point of the tool, while informing the responsible nurse, for them and if the client wishes by the researcher, telephone psychological counseling was performed. After completion, questionnaires were collected and analyzed. Data analysis using SPSS software version 19 in two sections of descriptive statistics (frequency, percentage, mean and standard deviation) and inferential statistics (Pearson correlation coefficient, independent t-test, and analysis of variance) and a significance level of less than 0.05 0 was considered. Results: In this study, 207 patients with myocardial infarction participated and one person was excluded from the study due to the incompleteness of the questionnaire. 72.8% of patients were male with a mean age of 57.97 ±12.49 years, 92.7% were married and 34.5% were self-employed. 35.9% had a history of hypertension and 24.3% had a history of diabetes. 90.8% of patients had insurance and 81.6% had a history of the previous hospitalization. The mean score of death anxiety in patients with myocardial infarction was 6.26 ± 1.62 (moderate). Most patients (43.7%) had moderate death anxiety. The mean score of demoralization syndrome was 11.88±5.34 (severe). Most patients (60.7%) had severe demoralization syndrome. Conclusion: In response to the research questions, the findings indicated that the rate of death anxiety in patients with myocardial infarction was moderate and the rate of depressive symptoms was high. Due to the nature of heart disease and the destructive nature of both complications of death anxiety and low mood syndrome, it is necessary to plan to reduce these complications as soon as possible. Obtain psychological information and use nursing interventions. Also in response to research questions, the results showed that some demographic factors such as age and education and some disease characteristics such as the duration of previous hospitalization and co-morbidity with other diseases can predict death anxiety and mood swings in this Patients should be involved, so for higher effectiveness, it is recommended to identify and pay attention to these factors in planning and interventions.