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. 2020 Dec;19(8):740-747.
doi: 10.1177/1474515120919387. Epub 2020 Jun 3.

Self-rated stress and experience in patients with Takotsubo syndrome: a mixed methods study

Runa Sundelin  1 , Chatarina Bergsten  1 , Per Tornvall  1 , Patrik Lyngå  1
Affiliations

Self-rated stress and experience in patients with Takotsubo syndrome: a mixed methods study

Runa Sundelin et al. Eur J Cardiovasc Nurs. 2020 Dec.

Abstract

Background: A relation to stress and stressful triggers is often, but not always, described in patients with Takotsubo syndrome. Few studies have focused on patients' self-rated stress in combination with qualitative experiences of stress in Takotsubo syndrome.

Aims: The aim of this study was to describe stress before and after the onset of Takotsubo syndrome.

Methods: Twenty patients were recruited from five major hospitals in Stockholm, Sweden between December 2014 and November 2018. A mixed methods design was used containing the validated questionnaire, perceived stress scale (PSS-14) filled in at baseline and at a 6 and 12-month follow-up, respectively. Qualitative interviews were made at the 6-month follow-up.

Results: Self-rated stress, measured by the perceived stress scale, showed stress levels above the cut-off value of 25, at the onset of Takotsubo syndrome (median 30.5). Stress had decreased significantly at the 12-month follow-up (median 20.5, P = 0.039) but remained high in one third of the patients. Qualitative interviews confirmed a high long-term stress and half of the patients had an acute stress trigger before the onset of Takotsubo syndrome. The qualitative interviews showed that the patients had reflected on and tried to find ways to deal with stress, but for many this was not successful.

Conclusion: Patients with Takotsubo syndrome reported long-term stress sometimes with an acute stress trigger before the onset of Takotsubo syndrome. Stress decreased over time but remained high for a considerable number of patients. Despite reflection over stress and attempts to deal with stress many were still affected after 6 months. New treatment options are needed for patients with Takotsubo syndrome.

Keywords: PSS-14; Takotsubo syndrome; perceived stress scale; stress.

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Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
The perceived stress scale (PSS-14) total scale at baseline, 6 and 12 months and factors 1 (stress) and 2 (coping) at baseline, 6 and 12 months. Median values and interquartile ranges (IQRs) are given in box plots. P values for change over time (Friedman’s test): total scale P=0.039, factor 1 P=0.137, factor 2 P=0.081.
Figure 2.
Figure 2.
The results from the qualitative interviews presented as Theme, Categories and Sub-Categories.
See this image and copyright information in PMC

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