Status after Hospital Discharge: An Observational Study of the Progression of Patients’ Mental Health Symptoms Six Weeks after Hospital Discharge
Abstract
:1. Introduction
2. Methodology and Materials
2.1. Study Design and Data Collection
2.2. Ethics Statement
2.3. Inclusion & Exclusion Criteria
2.4. Sample Size Calculation
2.5. Outcome Measures
2.5.1. GAD-7
2.5.2. PHQ-9
2.5.3. WHO-5
2.6. Statistical Analysis
3. Results
3.1. Demographic Information of the Respondents
3.2. Association Analysis Using Chi-Square/Fisher Exact Test
3.3. Mean Score Changes from Baseline to Six Weeks (Paired Sample t-Test)
3.4. Predictors of Likely Anxiety, Depression, and Wellbing (Logistic Regression)
4. Discussion
4.1. Anxiety
4.2. Major Depression Disorder
4.3. Well-Being
5. Limitations
6. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Appendix A
B | S.E. | Wald | df | Sig. | Exp(B) | 95% C.I. for EXP(B) | |||
---|---|---|---|---|---|---|---|---|---|
Lower | Upper | ||||||||
Age | ≤25 y | 1.125 | 3 | 0.771 | |||||
26–40 y | 0.127 | 0.842 | 0.023 | 1 | 0.880 | 1.135 | 0.218 | 5.917 | |
41–60 y | 0.190 | 0.902 | 0.044 | 1 | 0.833 | 1.209 | 0.206 | 7.089 | |
>60 | 1.121 | 1.186 | 0.894 | 1 | 0.344 | 3.069 | 0.300 | 31.393 | |
Gender | Male | 0.247 | 2 | 0.884 | |||||
Female | 0.295 | 0.594 | 0.247 | 1 | 0.619 | 1.344 | 0.420 | 4.303 | |
Other | 38.169 | 20,341.982 | 0.000 | 1 | 0.999 | 3772 × 1016 | 0.000 | ||
Ethnicity | Caucasian | 3.728 | 4 | 0.444 | |||||
Indigenous | −18.895 | 13,525.265 | 0.000 | 1 | 0.999 | 0.000 | 0.000 | ||
Asian | 0.601 | 0.840 | 0.512 | 1 | 0.474 | 1.824 | 0.352 | 9.453 | |
African descendants | −0.991 | 1.211 | 0.669 | 1 | 0.413 | 0.371 | 0.035 | 3.988 | |
Other | 1.648 | 1.098 | 2.252 | 1 | 0.133 | 5.195 | 0.604 | 44.689 | |
Education level | Less than high school | 1.112 | 2 | 0.574 | |||||
High school | 0.729 | 1.099 | 0.440 | 1 | 0.507 | 2.073 | 0.241 | 17.861 | |
Post-secondary education | 0.086 | 1.129 | 0.006 | 1 | 0.939 | 1.090 | 0.119 | 9.960 | |
Housing status | Own home | 0.406 | 2 | 0.816 | |||||
Rented accommodation | −0.402 | 0.786 | 0.262 | 1 | 0.609 | 0.669 | 0.143 | 3.123 | |
Live with family or friends | −0.493 | 0.824 | 0.358 | 1 | 0.549 | 0.611 | 0.121 | 3.071 | |
Employment status | Unemployed | −0.728 | 0.622 | 1.371 | 1 | 0.242 | 0.483 | 0.143 | 1.633 |
GAD-7 score at baseline | 1.451 | 0.576 | 6.350 | 1 | 0.012 | 4.268 | |||
Constant | −1.279 | 1.396 | 0.840 | 1 | 0.359 | 0.278 |
B | S.E. | Wald | df | Sig. | Exp(B) | 95% C.I. for EXP(B) | ||||
---|---|---|---|---|---|---|---|---|---|---|
Lower | Upper | |||||||||
Age | ≤25 y | 1.266 | 3 | 0.737 | ||||||
26–40 y | −0.170 | 0.851 | 0.040 | 1 | 0.841 | 0.843 | 0.159 | 4.468 | ||
41–60 y | 0.404 | 0.906 | 0.198 | 1 | 0.656 | 1.498 | 0.253 | 8.850 | ||
>60 | 0.844 | 1.146 | 0.542 | 1 | 0.461 | 2.325 | 0.246 | 21.971 | ||
Gender | Male | 0.801 | 2 | 0.670 | ||||||
Female | 0.512 | 0.572 | 0.801 | 1 | 0.371 | 1.669 | 0.544 | 5.121 | ||
Other | 38.789 | 20,133.183 | 0.000 | 1 | 0.998 | 7014 × 1016 | 0.000 | |||
Ethnicity | Caucasian | 2.016 | 4 | 0.733 | ||||||
Indigenous | −19.277 | 13,391.057 | 0.000 | 1 | 0.999 | 0.000 | 0.000 | |||
Asian | −0.735 | 0.837 | 0.772 | 1 | 0.380 | 0.479 | 0.093 | 2.471 | ||
African descendants | 0.046 | 1.036 | 0.002 | 1 | 0.965 | 1.047 | 0.137 | 7.981 | ||
Other | 1.170 | 1.132 | 1.069 | 1 | 0.301 | 3.224 | 0.351 | 29.636 | ||
Education level | Less than high school | 0.692 | 2 | 0.708 | ||||||
High school | 0.006 | 1.048 | 0.000 | 1 | 0.995 | 1.007 | 0.129 | 7.855 | ||
Post-secondary education | −0.557 | 1.118 | 0.248 | 1 | 0.618 | 0.573 | 0.064 | 5.124 | ||
Housing status | Own home | 2.571 | 2 | 0.276 | ||||||
Rented accommodation | −0.497 | 0.793 | 0.393 | 1 | 0.531 | 0.609 | 0.129 | 2.876 | ||
Live with family or friends | −1.324 | 0.842 | 2.474 | 1 | 0.116 | 0.266 | 0.051 | 1.385 | ||
Employment status | Unemployed | 0.051 | 0.615 | 0.007 | 1 | 0.934 | 1.052 | 0.315 | 3.511 | |
PHQ-9 score at baseline | 1.396 | 0.598 | 5.441 | 1 | 0.020 | 4.038 | 1.250 | 13.046 | ||
Constant | −0.448 | 1.359 | 0.109 | 1 | 0.742 | 0.639 |
B | S.E. | Wald | df | Sig. | Exp(B) | 95% C.I. for EXP(B) | |||
---|---|---|---|---|---|---|---|---|---|
Lower | Upper | ||||||||
Age | ≤25 y | 1.788 | 3 | 0.618 | |||||
26–40 y | 0.215 | 0.893 | 0.058 | 1 | 0.810 | 1.239 | 0.215 | 7.130 | |
41–60 y | 0.716 | 1.007 | 0.506 | 1 | 0.477 | 2.046 | 0.284 | 14.722 | |
>60 | −0.971 | 1.477 | 0.432 | 1 | 0.511 | 0.379 | 0.021 | 6.852 | |
Gender | Male | 1.032 | 2 | 0.597 | |||||
Female | 0.139 | 0.684 | 0.041 | 1 | 0.839 | 1.149 | 0.301 | 4.388 | |
Other | −1.319 | 1.539 | 0.735 | 1 | 0.391 | 0.267 | 0.013 | 5.456 | |
Ethnicity | Caucasian | 0.400 | 4 | 0.982 | |||||
Indigenous | −0.135 | 1.368 | 0.010 | 1 | 0.922 | 0.874 | 0.060 | 12.762 | |
Asian | 0.347 | 0.893 | 0.151 | 1 | 0.698 | 1.414 | 0.246 | 8.138 | |
African descendants | −0.419 | 1.101 | 0.145 | 1 | 0.704 | 0.658 | 0.076 | 5.695 | |
Other | −0.114 | 1.159 | 0.010 | 1 | 0.922 | 0.892 | 0.092 | 8.646 | |
Education level | Less than high school | 2.211 | 2 | 0.331 | |||||
High school | −1.290 | 1.205 | 1.147 | 1 | 0.284 | 0.275 | 0.026 | 2.919 | |
Post-secondary education | −1.918 | 1.310 | 2.142 | 1 | 0.143 | 0.147 | 0.011 | 1.917 | |
Housing status | Own home | 0.512 | 2 | 0.774 | |||||
Rented accommodation | −0.210 | 0.848 | 0.061 | 1 | 0.804 | 0.810 | 0.154 | 4.271 | |
Live with family or friends | 0.354 | 0.971 | 0.133 | 1 | 0.716 | 1.424 | 0.212 | 9.551 | |
Employment status | Unemployed | −0.215 | 0.663 | 0.105 | 1 | 0.746 | 0.807 | 0.220 | 2.957 |
Previous mental health diagnosis | Depression/anxiety | 4.170 | 4 | 0.383 | |||||
Bipolar disorder | 0.598 | 0.783 | 0.583 | 1 | 0.445 | 1.818 | 0.392 | 8.427 | |
Psychosis | 1.370 | 0.984 | 1.938 | 1 | 0.164 | 3.934 | 0.572 | 27.050 | |
Alcohol drug abuse | 2.351 | 1.455 | 2.613 | 1 | 0.106 | 10.501 | 0.607 | 181.792 | |
Other | 0.331 | 0.855 | 0.150 | 1 | 0.699 | 1.392 | 0.261 | 7.431 | |
Poor well-being (WHO-5) at baseline | 2.464 | 0.662 | 13.857 | 1 | 0.000 | 11.749 | 3.211 | 42.990 | |
Constant | 0.095 | 1.517 | 0.004 | 1 | 0.950 | 1.100 |
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Variables | N = 88 | % |
---|---|---|
Gender | ||
Male | 28 | 31.8 |
Female | 55 | 62.5 |
Other | 5 | 5.7 |
Age (Years) | ||
≤25 | 21 | 23.9 |
26–40 | 34 | 38.6 |
41–60 | 24 | 27.3 |
>60 | 9 | 10.2 |
Ethnicity | ||
White | 60 | 68.2 |
Indigenous | 4 | 4.5 |
African | 7 | 8.0 |
Asian | 12 | 13.6 |
Other | 5 | 5.7 |
Educational level | ||
Less than high school | 6 | 6.8 |
High school | 39 | 44.3 |
Postsecondary education | 43 | 48.9 |
Relationship status | ||
Single | 54 | 61.4 |
Separated/divorced | 11 | 12.5 |
Partnered/married | 23 | 26.1 |
Employment status | ||
Employed | 34 | 38.6 |
Unemployed | 40 | 45.4 |
Student | 7 | 8.0 |
Retired | 7 | 8.0 |
Housing status | ||
Own home | 25 | 28.4 |
Rented accommodation | 33 | 37.5 |
Live with family or friend | 30 | 34.1 |
Primary Mental Health Diagnosis | ||
Depression/anxiety | 34 | 38.6 |
Bipolar disorder | 18 | 20.5 |
Psychosis | 14 | 15.9 |
Alcohol, drug use/abuse | 7 | 8.0 |
Other | 15 | 17.0 |
Measures | Baseline n (%) | Six Weeks after Discharge n (%) | Total | Chi Square/ Fisher Exact | p-Value |
---|---|---|---|---|---|
GAD-7 1 | |||||
At most low anxiety | 46(52.3%) | 51 (58.0%) | 97 (55.1%) | 0.574 | 0.449 |
Moderate-to-severe anxiety | 42(47.7%) | 37 (42.0%) | 79 (44.9%) | ||
PHQ-9 2 | |||||
At most mild MDD | 33 (37.5%) | 42 (47.7%) | 75 (42.6%) | 1.882 | 0.170 |
Moderate-to-severe MDD | 55 (62.5%) | 46 (52.3%) | 101 (57.4%) | ||
WHO-5 3 | |||||
Good well-being | 53 (60.2%) | 41 (46.6%) | 94 (53.4%) | 3.288 | 0.070 |
Poor well-being | 35 (39.8%) | 47 (53.4%) | 82 (46.6%) |
Measure | Responses, n | Scores | Mean Difference (95% CI) | p-Value | t-Value | ||
---|---|---|---|---|---|---|---|
Baseline Score, Mean (SD) | Six-Week Score, Mean (SD) | Change from Baseline, % | |||||
GAD-7 1 | 88 | 9.49 (5.57) | 8.89 (6.17) | −6.35% | (−0.62–1.83) | 0.331 | 0.977 |
PHQ-9 2 | 88 | 12.19 (6.79) | 11.21 (7.71) | −8.12% | (−0.48–2.46) | 0.185 | 1.337 |
WHO-5 3 | 88 | 53.14 (24.63) | 51.18 (25.90) | −3.68% | (−3.43–7.34) | 0.473 | 0.721 |
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Mao, W.; Shalaby, R.; Owusu, E.; Elgendy, H.; Shalaby, N.; Agyapong, B.; Nichols, A.; Eboreime, E.; Nkire, N.; Agyapong, V.I.O. Status after Hospital Discharge: An Observational Study of the Progression of Patients’ Mental Health Symptoms Six Weeks after Hospital Discharge. J. Clin. Med. 2023, 12, 7559. https://doi.org/10.3390/jcm12247559
Mao W, Shalaby R, Owusu E, Elgendy H, Shalaby N, Agyapong B, Nichols A, Eboreime E, Nkire N, Agyapong VIO. Status after Hospital Discharge: An Observational Study of the Progression of Patients’ Mental Health Symptoms Six Weeks after Hospital Discharge. Journal of Clinical Medicine. 2023; 12(24):7559. https://doi.org/10.3390/jcm12247559
Chicago/Turabian StyleMao, Wanying, Reham Shalaby, Ernest Owusu, Hossam Elgendy, Nermin Shalaby, Belinda Agyapong, Angel Nichols, Ejemai Eboreime, Nnamdi Nkire, and Vincent I. O. Agyapong. 2023. "Status after Hospital Discharge: An Observational Study of the Progression of Patients’ Mental Health Symptoms Six Weeks after Hospital Discharge" Journal of Clinical Medicine 12, no. 24: 7559. https://doi.org/10.3390/jcm12247559