Available literature demonstrates that major depressive disorder (MDD) is commonly underdiagnosed and undertreated in patients suffering from heart disease or diabetes even though it is usually linked to undesirable clinical and psychological outcomes. More importantly, current research reveals that patients with MDD and heart disease or diabetes are at an elevated risk of succumbing to both morbidity and mortality, especially in adulthood (Barlow & Durand, 2008).
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By developing a framework through which risk factors associated with the development of MDD among adult patients with heart disease or diabetes can be easily identified, this study aims to reduce the complexity and increasing chronic disease burden by half.
The current study will aim to prove or disapprove the following hypotheses:
- H1: Early identification of risk factors associated with the development of MDD is positively correlated to good outcomes in the treatment and management of heart disease or diabetes.
- H2: Psychosocial factors and lifestyle issues are likely to predict subsequent MDD.
The quantitative study utilized a cluster-randomized intervention design to come with two sets of patients with a known medical history of heart disease or diabetes. According to Hayes et al (2000), a cluster-randomized design is effective in this type of study due to its capacity to evaluate the overall effects of an intervention strategy.
The target population for the study consisted of patients with heart disease or diabetes receiving treatment at Pine Breeze Hospital. Purposive sampling technique was used to select a sample of 20 patients, with the inclusion criteria being: the ability to express feelings, absence of any other medical conditions apart from diabetes, heart disease, and depression; and the patient must have suffered from the stated conditions for a period not less than two years. The age limit for inclusion was set at 25 years.
The selected sample was clustered into two groups, each consisting of 10 patients. The experimental group – the first 10 patients – was exposed to various intervention programs aimed at enabling them to cope with various psychosocial issues and lifestyle challenges in life for 4 weeks while the control group, also comprising of 10 patients, were left unattended for the same period.
Independent variables, according to StatSoft (n.d), are manipulated or varied, while the dependent variables are the responses that are measured to offer useful insights into the phenomena under study. As such, the various interventions provided to the first group over four weeks formed the independent variable whereas at-risk patients with depression and heart disease or diabetes in both groups formed the dependent variable.
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In ethical consideration, participants were adequately informed about the purpose of the study, and their rights were read out to them, including the right to informed consent, the right to confidentiality, and the right to discontinue participating in the study if they so wished. A letter was also sent to the hospital’s administrator to seek consent. The study neither utilized any deception techniques nor did the researcher offer any financial inducements to the subjects.
Data Collection & Analysis
Data was collected using a semi-structured questionnaire specifically designed to capture information on the risk factors. The questionnaire was administered to the two groups every week for the next four weeks. Data generated from the field was processed using SPSS for Windows to generate descriptive statistics as well as frequency distributions needed to answer the key research hypotheses.
Results and Conclusions
Results indicated that 55 percent of patients who were subjected to weekly interventions on how to control psychosocial issues and develop healthy lifestyles scored low marks in the variables that had been included in the questionnaire to measure the prevalence of MDD, while around 80 percent of patients in the control group posted high scores. These variables, which included the level of social inhibition, anxiety, emotional distress, diet, smoking, alcoholism, and negative affect, among others, proved the hypotheses right since their control through the various interventions administered to the experimental group not only posted positive outcomes, but their presence in the control group predicted subsequent MDD.
The task for psychologists and other medical professionals, therefore, is to develop strategies through which patients with diabetes or heart disease can be able to actively curtail the above-mentioned risk factors, which inarguably leads to the progression of MDD. Research indicates that MDD always leads to negative outcomes, especially when combined with diabetes or heart disease (Barlow & Durand, 2008). The knowledge of the risk factors involved in progressing MDD must therefore be in the public domain.
Barlow, D.H., & Durand, V.M. (2008). Abnormal Psychology: An Integrative approach. Hoboken, NJ: Sage Publications, Inc.
Hayes, R.J., Alexander, N.D.E., Bennett, S., & Cousens, S.N. (2000). Design and analysis issues in cluster-randomized trials of interventions against infectious diseases. Web.
StatSoft. (n.d.). Elementary concepts in statistics. Web.