Perception of a hectic hospital environment at admission relates to acute stress disorder symptoms in myocardial infarction patients.

Meister, Rebecca Elisabeth; Weber, Tania; Princip, Mary; Schnyder, Ulrich; Barth, Jürgen; Znoj, Hans Jörg; Schmid, Jean-Paul; von Känel, Roland (2016). Perception of a hectic hospital environment at admission relates to acute stress disorder symptoms in myocardial infarction patients. General hospital psychiatry, 39, pp. 8-14. Elsevier 10.1016/j.genhosppsych.2015.11.004

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OBJECTIVE

Hospital crowding is a public health problem that may impact on the quality of medical treatment and increase the risk of developing traumatic stress, e.g., after myocardial infarction (MI). This study examines whether subjective appraisal of crowding at hospital admission due to MI is associated with acute stress disorder (ASD) symptoms.

METHOD

We investigated 102 consecutive patients with acute MI within 48h after having reached stable circulatory conditions. The appraisal of crowding was measured by the retrospective assessment of the perception of a hectic hospital environment at admission. Furthermore, patients completed the Acute Stress Disorder Scale to rate the psychological stress reaction.

RESULTS

The perception of a hectic hospital environment was associated with the development of ASD symptoms (r=0.254, P=.013) independently of demographic, peritraumatic and medical factors. Post hoc analysis revealed associations with dissociative (r=0.211, P=.041), reexperiencing (r=0.184, P=.074) and arousal (r=0.179, P=.083) symptoms.

CONCLUSION

The findings suggest that, besides objective circumstances, the way hospital admission due to MI is perceived by the patient may influence the development of MI-triggered ASD symptoms. The psychological and physiological long-term outcomes of the perception of a hectic hospital environment and the role of preventive interventions need further examination.

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