Prevalencia de Sintomatología Depresiva en Pacientes con Diagnóstico de Insuficiencia Cardíaca Atendidos en una Clínica Ambulatoria de Bucaramanga en el 2021

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Autores:
Vargas-Cardozo, Sandra Milena
Tipo de recurso:
Trabajo de grado de pregrado
Fecha de publicación:
2023
Institución:
Universidad de Santander
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Repositorio Universidad de Santander
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spa
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https://repositorio.udes.edu.co
https://repositorio.udes.edu.co/handle/001/8058
Palabra clave:
Insuficiencia cardíaca
Depresión
Apoyo Social
Calidad de Vida
Heart Failure
Depression
Social Support
Quality of Life
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oai_identifier_str oai:repositorio.udes.edu.co:001/8058
network_acronym_str RUDES2
network_name_str Repositorio Universidad de Santander
repository_id_str
dc.title.spa.fl_str_mv Prevalencia de Sintomatología Depresiva en Pacientes con Diagnóstico de Insuficiencia Cardíaca Atendidos en una Clínica Ambulatoria de Bucaramanga en el 2021
dc.title.translated.none.fl_str_mv Prevalence of Depressive Symptomatology in Patients Diagnosed With Heart Failure Treated at an Outpatient Clinic in Bucaramanga in 2021
title Prevalencia de Sintomatología Depresiva en Pacientes con Diagnóstico de Insuficiencia Cardíaca Atendidos en una Clínica Ambulatoria de Bucaramanga en el 2021
spellingShingle Prevalencia de Sintomatología Depresiva en Pacientes con Diagnóstico de Insuficiencia Cardíaca Atendidos en una Clínica Ambulatoria de Bucaramanga en el 2021
Insuficiencia cardíaca
Depresión
Apoyo Social
Calidad de Vida
Heart Failure
Depression
Social Support
Quality of Life
title_short Prevalencia de Sintomatología Depresiva en Pacientes con Diagnóstico de Insuficiencia Cardíaca Atendidos en una Clínica Ambulatoria de Bucaramanga en el 2021
title_full Prevalencia de Sintomatología Depresiva en Pacientes con Diagnóstico de Insuficiencia Cardíaca Atendidos en una Clínica Ambulatoria de Bucaramanga en el 2021
title_fullStr Prevalencia de Sintomatología Depresiva en Pacientes con Diagnóstico de Insuficiencia Cardíaca Atendidos en una Clínica Ambulatoria de Bucaramanga en el 2021
title_full_unstemmed Prevalencia de Sintomatología Depresiva en Pacientes con Diagnóstico de Insuficiencia Cardíaca Atendidos en una Clínica Ambulatoria de Bucaramanga en el 2021
title_sort Prevalencia de Sintomatología Depresiva en Pacientes con Diagnóstico de Insuficiencia Cardíaca Atendidos en una Clínica Ambulatoria de Bucaramanga en el 2021
dc.creator.fl_str_mv Vargas-Cardozo, Sandra Milena
dc.contributor.advisor.none.fl_str_mv Carvajal-Estupiñán, Juan Fernando
Rueda-García, Paola Andrea
Medina-Ortiz, Oscar
dc.contributor.author.none.fl_str_mv Vargas-Cardozo, Sandra Milena
dc.contributor.jury.none.fl_str_mv Pérez-García, Gladys Nora
Aguilera-Rodríguez, Hector Javier
Llanez-Anaya, Elkin Rene
dc.subject.proposal.spa.fl_str_mv Insuficiencia cardíaca
Depresión
Apoyo Social
Calidad de Vida
topic Insuficiencia cardíaca
Depresión
Apoyo Social
Calidad de Vida
Heart Failure
Depression
Social Support
Quality of Life
dc.subject.proposal.eng.fl_str_mv Heart Failure
Depression
Social Support
Quality of Life
description Digital
publishDate 2023
dc.date.accessioned.none.fl_str_mv 2023-02-20T16:43:04Z
dc.date.available.none.fl_str_mv 2023-02-20T16:43:04Z
dc.date.issued.none.fl_str_mv 2023-02-08
dc.type.none.fl_str_mv Trabajo de grado - Especialización
dc.type.coar.none.fl_str_mv http://purl.org/coar/resource_type/c_7a1f
dc.type.coarversion.none.fl_str_mv http://purl.org/coar/version/c_71e4c1898caa6e32
dc.type.content.none.fl_str_mv Text
dc.type.driver.none.fl_str_mv info:eu-repo/semantics/bachelorThesis
dc.type.redcol.none.fl_str_mv http://purl.org/redcol/resource_type/TP
dc.type.version.none.fl_str_mv info:eu-repo/semantics/submittedVersion
format http://purl.org/coar/resource_type/c_7a1f
status_str submittedVersion
dc.identifier.instname.none.fl_str_mv Universidad de Santander
dc.identifier.local.none.fl_str_mv T 63.23 V173p
dc.identifier.reponame.none.fl_str_mv Repositorio Digital Universidad de Santander
dc.identifier.repourl.none.fl_str_mv https://repositorio.udes.edu.co
dc.identifier.uri.none.fl_str_mv https://repositorio.udes.edu.co/handle/001/8058
identifier_str_mv Universidad de Santander
T 63.23 V173p
Repositorio Digital Universidad de Santander
url https://repositorio.udes.edu.co
https://repositorio.udes.edu.co/handle/001/8058
dc.language.iso.none.fl_str_mv spa
language spa
dc.relation.references.none.fl_str_mv Ziaeian B, Fonarow GC. Epidemiology and aetiology of heart failure. Nat Rev Cardiol 2016; 13: 368 – 78.
Carels, R. A. The association between disease severity, functional status, depression and daily quality of life in congestive heart failure patients. Quality of Life Research 2004; 13(1), 63–72.
Pintor L. Insuficiencia cardiaca y enfermedad depresiva, una frecuente combinación tantas veces olvidada. Revista Española de Cardiología 2006; 761-765.
Kupfer DJ. Longterm treatment of depression. London: John Wiley & Sons LTD; 1992b. p. 33-52.
Gottlieb SS, Khatta M, Friedmann E, Einbinder L, Katzen S, Baker B, et al. The influence of age, gender, and race on the prevalence of depression in heart failure patients. J Am Coll Cardiol. 2004;43(9):1542-9.
Pihl E, Jacobsson, Fridlund B, Stromberg A, Martensson J. Depression and health-related quality of life in elderly patients suffering from heart failure and their spouses: a comparative study. Europe Heart Failure 2005; 7(4): 583-9.
Grupo de trabajo de la Guía de Práctica Clínica sobre el Manejo de la Depresión en el Adulto. Guía de Práctica Clínica sobre el Manejo de la Depresión en el Adulto. Ministerio de Sanidad, Servicios Sociales e Igualdad. Agencia de Evaluación de Tecnologías Sanitarias de Galicia (avalia-t); 2014; Guías de Práctica Clínica en el SNS: Avalia-t 2013/06.
Aloisi G, Zucchelli A, Aloisi B, Romanelli G, Marengoni A. Depression and heart failure: an intricate relationship. Monaldi Arch Chest Dis. 2019; 11;89.
Camacho TC, Roberts RE, Lazarus NB, Kaplan GA, Cohen RD. Physical activity and depression: evidence from the Alameda County Study. Am J Epidemiol 1991; 134: 220-31.
Koenig HG. Depression in hospitalized older patients with congestive heart failure. Gen Hosp Psychiatry. 1998; 20(1):29–43.
Szyguła-Jurkiewicz B, Zakliczynski M, Owczarek A, Partyka R, Moscinski M, Pudlo R, et al. Low health-related quality of life is a predictor of major adverse cardiovascular events in patients with chronic non ischemic Heart Failure. Kardiochir Torakochirurgia Pol. 2014;11:283.
Achury-Saldaña, DM. Autocuidado y adherencia en pacientes con falla cardiaca. Aquichan 2007 Oct; 7(2): 139-160.
Orso F, Fabbri G, Maggioni AP. Epidemiology of heart failure. Handb Exp Pharmacol 2017; 243: 15 – 33.
Heidenreich PA, Albert NM, Allen LA, Bluemke DA, Butler J, Fonarow GC, Ikonomidis JS, Khavjou O, Konstam MA, Maddox TM, Nichol G, Pham M, Piña IL, Trogdon JG. Forecasting the impact of heart failure in the United States: a policy statement from the American Heart Association. Circ Heart Fail (2013) 6:606–619.
De la Fuente-Cid R, Hermida-Ameijeiras A, Pazo-Núñez M, Lado-Lado F. Epidemiología de la insuficiencia cardiaca. An Med Interna (Madrid) 2007; 24: 500-504.
Gómez E. Introducción, epidemiología de la falla cardiaca e historia de las clínicas de falla cardiaca en Colombia. Revista Colombiana de Cardiología, 2016; ISSN: 0120-5633, Vol: 23, Page: 6-12.
Ospina AV, Gamarra G. Características clínicas y epidemiológicas de la insuficiencia cardiaca en el Hospital Universitario Ramón González Valencia de Bucaramanga, Colombia. Salud UIS. 2004; 36:125-31.
Malhi GS, Mann JJ. Depression. Lancet. 2018 nov 24;392(10161):2299-2312.
Moudgil R, Haddad H. Depression in heart failure. Curr Opin Cardiol. 2013;28(2):249-58.
Mbakwem A, Aina F, Amadi C. Expert Opinion-Depression in Patients with Heart Failure: ¿Is Enough Being Done? Cardiac failure review, 2016;2(2), 110–112.
Johansson P, Dahlstrom U, Brostrom A. Consequences and predictors of depression in patients with chronic heart failure: implications for nursing care and future research. Progress in cardiovascular nursing. 2006;21(4):202-11.
Sin MK. Personal characteristics predictive of depressive symptoms in Hispanics with heart failure. Issues Ment Health Nurs. 2012;33(8):522-7.
Graven L. J, Martorella G, Gordon G, Grant JS, Higgins MK. Predictors of depression in outpatients with heart failure: An observational study. International journal of nursing studies. 2017; 69, 57–65.
Eisele M, Harder M, Rakebrandt A, Boczor S, Marx G, Blozik E, Träder JM, Störk S, Herrmann-Lingen C, Scherer M. Association of depression and anxiety with adherence in primary care patients with heart failure-cross-sectional results of the observational RECODE-HF cohort study [published online ahead of print. Fam Pract. 2020; 37(5):695-702.
Van der Wal MH, Jaarsma T. Adherence in heart failure in the elderly: problem and possible solutions. Int J Cardiol. 2008;125(2):203-8.
Casey E, Hughes JW, Waechter D, Josephson R, Rosneck J. Depression predicts failure to complete phase-II cardiac rehabilitation. Journal of behavioral medicine. 2008;31(5):421-31.
Bauer LK, Caro MA, Beach SR, Mastromauro CA, Lenihan E, Januzzi JL, Huffman JC. Effects of depression and anxiety improvement on adherence to medication and health behaviors in recently hospitalized cardiac patients. Am J Cardiol. 2012;109(9):1266-71.
Jünger J, Schellberg D, Müller-Tasch T, Raupp G, Zugck C, Haunstetter A, Zipfel S, Herzog W, Haass M. Depression increasingly predicts mortality in the course of congestive heart failure. Eur J Heart Fail. 2005;7(2):261-7.
Grippo AJ, Johnson AK. Stress, depression and cardiovascular dysregulation: a review of neurobiological mechanisms and the integration of research from preclinical disease models. Stress. 2009;12(1):1-21.
Jiménez JA, Peterson CT, Mills PJ. Neuroimmune Mechanisms of Depression in Adults with Heart Failure. Methods Mol Biol. 2018; 1781:145-169.
Liu RH, Pan JQ, Tang XE, Li B, Liu SF, Ma WL. The role of immune abnormality in depression and cardiovascular disease. J Geriatr Cardiol. 2017;14(11):703-710.
Guidi J, Offidani E, Rafanelli C, Roncuzzi R, Sonino N, Fava GA. The assessment of allostatic overload in patients with congestive heart failure by clinimetric criteria. Stress and Health. 2016 feb;32(1):63-9.
Lane DA, Chong AY, Lip GYH. Psychological interventions for depression in heart failure. Cochrane Database of Systematic Reviews 2005; Issue 1. Art. No.: CD003329
Gnanasekaran G. Epidemiology of depression in heart failure. Heart Fail Clin. 2011;7(1):1-10.
Joynt KE, Whellan DJ, O'connor CM. Why is depression bad for the failing heart? A review of the mechanistic relationship between depression and heart failure. J Card Fail. 2004;10(3):258-71.
Mastrogiannis D, Giamouzis G, Dardiotis E, Karayannis G, Chroub-Papavaiou A, Kremeti D, Spiliopoulos K, Georgoulias P, Koutsias S, Bonotis K, Mantzorou M, Skoularigis J, Hadjigeorgiou GM, Butler J, Triposkiadis F. Depression in patients with cardiovascular disease. Cardiology research and practice. 2012; 2012:794762.
Cassiani-Miranda, C., Cuadros-Cruz, K., Torres Pinzón, H., Scoppetta, O., Pinzón-Tarrazona, J., López-Fuentes, W., 2019. Validez del Cuestionario de Salud del Paciente-9 (PHQ-9) para cribado de depresión en adultos usuarios de atención primaria en Bucaramanga, Colombia. Revista Colombiana de Psiquiatría. 2020.
Celano CM, Villegas AC, Albanese AM, Gaggin HK, Huffman JC. Depression and Anxiety in Heart Failure: A Review. Harv Rev Psychiatry. 2018;26(4):175-184.
Montes Pena F, Amorim A, Fassbender C, De Oliveira RF, Cardozo C. Insuficiencia cardíaca y depresión. Revista Insuficiencia Cardiaca. Insuf Card 2011;(Vol 6) 4:179-187.
Dhar AK., Barton DA. (2016). Depression and the Link with Cardiovascular Disease. Frontiers in psychiatry. 2016; Vol 7, 33.
Y. Shimizu S. Yamada F, Miyake F, Izumi T. The effects of depression on the course of functional limitations in patients with chronic heart failure. Journal of Cardiac Failure, 2011; vol. 17, no. 6, pp. 503–510.
Moraska AR, Chamberlain AM, Shah ND, Vickers KS, Rummans TA, Dunlay SM, Spertus JA, Weston SA, McNallan SM, Redfield MM, Roger VL. Depression, healthcare utilization, and death in heart failure: a community study. Circ Heart Fail. 2013 May;6(3):387-94.
Rodríguez J, Pastor M. Afrontamiento, apoyo social, calidad de vida y enfermedad. Psicothema. 1993, Vol 5 (Supl. 1), 349-372.
Cassel, J. La contribución del entorno social a la resistencia del anfitrión. Revista Estadounidense de Epidemiología. 1976; 104, 107-123.
Chung ML, Lennie TA, Dekker RL, Wu J R, Moser DK. Depressive symptoms and poor social support have a synergistic effect on event-free survival in patients with heart failure. Heart & lung: the journal of critical care, 2011; 40 (6), 492–501.
Chung ML, Moser DK, Lennie TA, Frazier SK. Perceived social support predicted quality of life in patients with heart failure, but the effect is mediated by depressive symptoms. Quality of life research: an international journal of quality of life aspects of treatment, care and rehabilitation, 2013; 22 (7), 1555–1563).
Schwartzmann L. Calidad de vida relacionada con la salud: aspectos conceptuales. Ciencia y enfermería. Diciembre de 2003;9(2).
Coelho R, Ramos S, Prata J, Bettencourt P, Ferreira A. Heart failure and health related quality of life. Clinical Practice of Epidemiology Mental Health 2005; 1: 19.
Alla F, Briançon S, Guillemin F, Juillière Y, Mertès PM, Villemot JP. Self-rating of quality of life provides additional prognostic information in heart failure. Insights into the EPICAL study. European Journal of Heart Failure, (2002)4(3), 337–343.
Luskin F, Reitz M, Newell K, Quinn T, Haskell W. A controlled pilot study of stress management training of elderly patients with congestive heart failure. Prev Cardiol 2002; 5: 168-172.
Smith L. Evaluation and treatment of depression in patients with heart failure. J Am Acad Nurse Pract. 2010;22(8):440-448.
Saveanu RV, Mayes T. Diagnosing depression in congestive heart failure. Heart Fail Clin. 2011;7(1):75-79.
Delville CL, McDougall G. A systematic review of depression in adults with heart failure: instruments and incidence. Issues Ment Health Nurs. 2008;29(9):1002-17.
Maixner SM, Struble L, Blazek M, Kales HC. Later-life depression and heart failure. Heart Fail Clin. 2011;7(1):47-58.
Chung ML, Moser DK, Lennie TA, Rayens MK. The effects of depressive symptoms and anxiety on quality of life in patients with heart failure and their spouses: testing dyadic dynamics using Actor-Partner Interdependence Model. Journal of psychosomatic research. 2009;67(1):39-5.
Friedman B, Lyness JM, Delavan RL, Chunyu L, Barker WH. Major depression and disability in older primary care patients with heart failure. Journal of geriatric psychiatry and neurology. 2008;21(2):111-22.
Patron E, Messerotti Benvenuti S, Lopriore V, Aratari J, Palomba D. Somatic-Affective, but not cognitive-depressive symptoms are associated with reduced health–related quality of life in patients with congestive heart failure. Psychosomatics. Mayo de 2017;58(3):281-91.
Skotzko CE. Symptom perception in CHF: (why mind matters). Heart Fail Rev. 2009;14(1):29-34.
Bellon, JA. Delgado A. Validez y fiabilidad del cuestionario de apoyo social funcional Duke-UNC-11. Sociedad Española de Medicina de Familia y Comunitaria. Atención Primaria, 1996; vol. 18, número 4, pp: 153-163.
Sánchez-Ropero EM, Vera-Giraldo CY, Navas-Ríos CM, Ortiz-Rangel SD, Rodríguez-Guevara C, Vargas-Montoya DM, Aguirre-Acevedo DC, Lugo-Agudelo LH. Validación para Colombia del cuestionario para la “Medición de la capacidad funcional en pacientes con falla cardíaca”. Revista Colombiana de Cardiología. 2018 ;25(6):356-65.
Lugo-Agudelo LH, Ortiz-Rangel SD, Rodríguez-Guevara C, Vargas-Montoya DM, Aguirre-Acevedo DC, Vera-Giraldo CY, Navas-Ríos CM. Validación del Minnesota Living with Heart Failure questionnaire (MLFHQ) en pacientes con falla cardíaca. Revista Colombiana de Cardiología. 2020 ;27(6):564-72.
Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40(5):373-383.
Charlson ME, Charlson RE, Peterson JC, Marinopoulos SS, Briggs WM, Hollenberg JP. The Charlson comorbidity index is adapted to predict costs of chronic disease in primary care patients. J Clin Epidemiol. 2008;61(12):1234-1240.
Suarez-Cuba M. identificación y utilidad de las herramientas para evaluar el apoyo social al paciente y al cuidador informal. Revista Médica La Paz, 2011; 17(1), 60-67.
Londoño N, Rogers H. Validación en Colombia del cuestionario MOS de apoyo social International Journal of Psychological Research, 2012; vol. 5, núm. 1, pp. 142-150.
Barrón-Lopez A. Fuertes FC. Apoyo social percibido: su efecto protector frente a los acontecimientos vitales estresantes. Revista de Psicología Social, 1992; 7 (1). pp. 53-59.
Murberg TA, Bru E, Aarsland T, Svebak S. Social support, social disability and their role as predictors of depression among patients with congestive heart failure. Scand J Soc Med. 1998;26(2):87–95.
Artinian NT, Artinian CG, Saunders MM. Identifying and Treating Depression in Patients With Heart Failure. The Journal of Cardiovascular Nursing, 2004; 19, S47–S56.
Riegel B, Carlson B. Is individual peer support a promising intervention for persons with heart failure? Journal of Cardiovascular Nursing, 2004; 19(3), 174–183.
Dunbar SB, Clark PC, Deaton C, Smith AL, De AK, O’Brien M. C. Family education and support interventions in heart failure: A pilot study. Nursing Research, 2005; 54(3), 158–166.
Ponikowski P, Voors AA. ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the special contribution of th. 2016; 18:891–975.
Butler J, Fonarow GC, Zile MR, Lam CS, Roessig L, Schelbert EB, Shah SJ , Bonow RO, Cleland JGF, Cody RJ, Chioncel O, Collins SP, Dunnmon P FG, Lefkowitz MP, Marti CN, McMurray JJ, Misselwitz F, Nodari S, O’Connor C P, MA, Pieske B, Pitt B, Rosano G, Sabbah HN, Senni M, Solomon SD SN, Teerlink JR, Georgiopoulou VV GM. Developing therapies for heart failure with preserved ejection fraction: current state and future directions. JACC. Hear Fail. 2014; 2:97–112.
Dávila-Spinetti D, Donis H, Jose H, González M, Sánchez F. Fisiopatología, diagnóstico y tratamiento médico de la insuficiencia cardiaca congestiva. Revista Venezolana de Endocrinología y Metabolismo. 2010; 8(3), 88-98.
Failure H, Hfa A, Esc D, Miembros A, Piotr DT, Presidente P, et al. Guía ESC 2016 sobre el diagnóstico y tratamiento de la insuficiencia cardiaca aguda y crónica Grupo de Trabajo de la Sociedad Europea de Cardiología de diagnóstico y tratamiento. 2017;69.
McCullough PA, Philbin EF, Spertus JA, Kaatz S, Sandberg KR, Weaver WD. Confirmation of a heart failure epidemic: findings from the Resource Utilization Among Congestive Heart Failure (REACH) study.J Am Coll Cardiol. 2002; 39:60-69.
Speranza-Sánchez M, Adames A, Benavides A, Paulino A, González B, Umaña CD, Chaves D,Quesada, Rodríguez I B, Chaves G, Barquero JP, García LR, Bulnes JM, Mendoza M, Fausto SR, Correa L, Iglesias RM. Primer Consenso Centroamericano y El Caribe de Sociedades de Cardiología para el diagnóstico y manejo de la Falla Cardíaca. Revista Costarricense de Cardiología. 2015; 17(1-2), 5-49.
Kelder JC, Cramer MJ, van Wijngaarden J, van Tooren R, Mosterd A, Moons KG, et al. The diagnostic value of physical examination and additional testing in primary care patients with suspected heart failure. Circulation. 2011;124(25):2865-73.
McKee PA, Castelli WP, McNamara PM, Kannel WB. The natural history of congestive heart failure: the Framingham study. The New England journal of medicine. 1971;285(26):1441-6.
Goldman L, Hashimoto B, Cook EF, Loscalzo A. Comparative reproducibility and validity of systems for assessing cardiovascular functional class: advantages of a new specific activity scale. Circulation. 1981 Dec;64(6):1227-34.
Schulz PE, Arora G. Depression. Continuum (Minneap Minn). Behavioral Neurology and Neuropsychiatry. 2015; 21(3):756-71.
Pérez-Padilla, EA. Cervantes-Ramírez, VM. Hijuelos-García, NA. Pineda-Cortés, JC. Salgado-Burgos, H. Prevalencia, causas y tratamiento de la depresión Mayor. Revista biomédica. 2017; 28(2), 73-98.
Organización Mundial de la Salud, OMS, disponible en: https://www.who.int/es/news-room/fact-sheets/detail/depression.
Andrade L, Caraveo-Anduaga JJ, Berglund P, Bijl RV, De Graaf R, Vollebergh W, et al. The epidemiology of major depressive episodes: results from the International Consortium of Psychiatric Epidemiology (ICPE) Surveys. Int J Methods Psychiatr Res 2003; 12: 3-21.
American Psychiatric Association. DSM-5. Manual Diagnóstico y Estadístico de los Trastornos Mentales.DSM-5®. Edición: 5ª. Editorial Médica Panamericana. 2014; 492 pp.
Organización Panamericana de la Salud. Clasificación estadística internacional de las enfermedades y problemas relacionados con la salud (CIE-10). Washington, D.C: OPS; 1995.
Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. Journal of general internal medicine. 2001;16(9):606-13.
Kocalevent RD, Hinz A, Brahler E. Standardization of the depression screener patient health questionnaire (PHQ-9) in the general population. Gen Hosp Psychiatry. 2013;35(5):551-5.
Williams JW, Jr., Pignone M, Ramirez G, Perez Stellato C. Identifying depression in primary care: a literature synthesis of case-finding instruments. Gen Hosp Psychiatry. 2002;24(4):225-37.
Dickstein K, Cohen-Solal A, Filippatos G et al.ESC Guidelines for the diagnosis andtreatment of acute and chronic heart failure 2008: the Task Force for the Diagnosisand Treatment of Acute and Chronic Heart Failure 2008 of the European Society ofCardiology. Developed in collaboration with the Heart Failure Association of the ESC(HFA) and endorsed by the European Society of Intensive Care Medicine (ESICM). Eur Heart J. 2008; 29:2388-2442.
Kop WJ, Synowski SJ, Gottlieb SS. Depression in heart failure: biobehavioral mechanisms. Heart Fail Clin. 2011;7(1):23-38.
Luttik ML, Jaarsma T, Moser D, Sanderman R, van Veldhuisen DJ. The importance and impact of social support on outcomes in patients with heart failure: an overview of the literature. The Journal of cardiovascular nursing, 2005; 20(3), 162–169.
Krumholz HM, Butler J, Miller J, Vaccarino V, Williams CS, Mendes de Leon CF, Seeman TE, Kasl SV, Berkman LF. Prognostic importance of emotional support for elderly patients hospitalized with heart failure. 1998;97(10):958-64.
House JS, Umberson D, Landis KR. Structures and processes of social support. Ann Rev Sociol. 1988;14:293–318.
Suarez Cuba MA. Identificación y utilidad de las herramientas para evaluar el apoyo social al paciente y al cuidador informal. Rev. Méd. La Paz. 2011; 17 (1): 60-67.
Matud P, Caballeira M, López M, Marrero R, Ibáñez I. Apoyo social y salud: un análisis de género. Salud Mental 2002;25(2):32-37.
López M, Orueta M, Gómez S, Sánchez A, Carmona J, Alonso F. El rol del cuidador de personas dependientes y sus repercusiones sobre su calidad de vida y salud. REV CLIN MED FAM 2009; 2(7):332-334.
Pinto C, Lara R, Espinoza E, Montoya P. Propiedades psicométricas de la escala de apoyo social percibido de Zimet en personas mayores de Atención Primaria de Salud. 2014; 23(1-2): 85-89.
Terol M, López S, Neipp M, Rodríguez J, Pastor MA, Martín-Arago, M. Apoyo social e instrumentos de evaluación: revisión y clasificación. Anuario de psicología/The UB Journal of psychology, 2004; 35(1), 23–46.
Martín-Carbonell M, Cerquera-Córdoba A, Fernández-Daza M, Higuita JD, Galván G, Guerrero M, Riquelme A. Estructura factorial del Cuestionario de Apoyo Social MOS en ancianos colombianos con dolor crónico. Terapia psicológica, (2019)37(3), 211-224.
Vivaldi F. Barra E. Bienestar Psicológico, Apoyo Social Percibido y Percepción de Salud en Adultos Mayores. Terapia psicológica, 2012; 30(2), 23-29.
Friedmann E, Son H, Thomas SA, Chapa DW, Lee HJ. Poor social support is associated with increases in depression but not anxiety over 2 years in heart failure outpatients. The Journal of cardiovascular nursing, 2014; 29(1), 20–28.
Alvarado B, Zunzunegui M, Béland F, Bamvita J. Life course social and health conditions linked to frailty in Latin American older men and women. Journals of Gerontology: Medical Sciences, 2008; 63, 1399-1406.
Ministerio de Salud y Protección Social, Departamento Administrativo de ciencia, Tecnología e Innovación-Colciencias. Guía de práctica clínica para la prevención, diagnóstico, tratamiento y rehabilitación de la falla cardíaca en población mayor de 18 años B, C y D. Guía para profesionales de la Salud 2016).
Rector TS, Kubo SH, Cohn JN. Patient’s self-assessment of their congestive heart failure: Content, reliability and validity of a new measure: The Minnesota living with heart failure questionnaire. Heart Fail. 1987; 3:198---219.
Garin O, Soriano N, Ribera A, Ferrer M, Pont À, Alonso J, Permanyer G. Validación de la versión española del minnesota living with heart failure questionnaire. Revista Española de Cardiología. 2008;61(3):251-9.
Jaarsma T, Lesman-Leegte I, Hillege HL, Veeger NJ, Sanderman R, van Veldhuisen DJ. Depression and the usefulness of a disease management program in heart failure: insights from the COACH (Coordinating study evaluating Outcomes of Advising and Counseling in Heart failure) study. J Am Coll Cardiol. 2010;55(17):1837Y1843.
Mohd-Razali N, Bee Y. Power Comparisons of Shapiro-Wilk, Kolmogorov-Smirnov, Lilliefors & Anderson-Darling Tests. J Stat Model Anal, (2011) 2(1), 21-33. ISBN: 978-967-363-157-5.
Blanco-Restrepo JH, Maya-Mejía JM, Torres de Galvis Y. No Title. In: Salud MDE, Salud ELMDE. MINISTERIO DE SALUD RESOLUCION NUMERO 8430 DE 1993. 1993;1993(octubre 4):1–19.
Ortiz-Hernández L, López-Moreno S, Borges G. Desigualdad socioeconómica y salud mental: revisión de la literatura latinoamericana [Socioeconomic inequality and mental health: a Latin American literature review]. Cad Saude Publica. 2007 Jun;23(6):1255-72.
Araya R, Lewis G, Rojas G, Fritsch R. Education and income: which is more important for mental health? J Epidemiol Community Health 2003; 57:501-5.
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dc.publisher.faculty.none.fl_str_mv Facultad Ciencias Médicas y de la Salud
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dc.publisher.program.none.fl_str_mv Especialización en Medicina Familiar
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spelling Carvajal-Estupiñán, Juan Fernando8906241e-f1ae-40e2-9900-721b92f1cd9b-1Rueda-García, Paola Andrea6a4679d6-55d1-4fe6-b9b7-6246afceb9a7-1Medina-Ortiz, Oscard2bdec00-1617-4c52-bbc0-bfd05942e3a9-1Vargas-Cardozo, Sandra Milenab427a527-0741-44ba-b6e1-e06ad0bb084a-1Pérez-García, Gladys Nora805dbdd9-e9e4-4d9c-a65d-fc01438f07f3-1Aguilera-Rodríguez, Hector Javierc1efeec9-1fec-4957-bb83-b2cea78171fd-1Llanez-Anaya, Elkin Rene2a7ade74-0481-4c44-b798-8a34eecc089f-12023-02-20T16:43:04Z2023-02-20T16:43:04Z2023-02-08DigitalLa insuficiencia cardíaca constituye un problema de salud pública debido a su alta prevalencia, como consecuencia de esto se generan cambios físicos, emocionales y compromiso en la funcionalidad normal del paciente. Se ha encontrado una asociación entre depresión e insuficiencia cardíaca que puede tener un impacto negativo en la situación clínica del paciente. El objetivo de este estudio es establecer la prevalencia de sintomatología depresiva de importancia clínica en pacientes con diagnóstico de insuficiencia cardíaca atendidos en una clínica ambulatoria de Bucaramanga entre mayo y diciembre de 2021. Se realizó un estudio observacional, descriptivo de corte transversal, para evaluar la frecuencia y distribución de síntomas depresivos de importancia clínica en pacientes con diagnóstico de insuficiencia cardíaca mediante la aplicación del PHQ-9, y explorar su asociación con variables psicosociales tales como apoyo social percibido y calidad de vida mediante el cuestionario de apoyo social (MOS) y el Minnesota Living with Heart Failure Questionnaire (MLHFQ) respectivamente. Se incluyeron un total de 153 pacientes mayores de 18 años de los cuales 65.4% fueron del sexo masculino encontrando que el 17% de la población presentó sintomatología depresiva de importancia clínica. La relación entre PHQ-9 y apoyo social es negativa, esto significa que es inversamente proporcional a mayor apoyo social percibido menor puntaje en el PHQ-9 (P=0.179). Se encontró una correlación altamente significativa entre PHQ-9 y calidad de vida, a mayor impacto de la insuficiencia cardíaca en la calidad de vida mayor puntaje de síntomas depresivos de importancia clínica (P<0.001).Heart failure is a public health problem due to its high prevalence, which results in physical and emotional changes and compromises the patient's normal functioning. An association has been found between depression and heart failure that can have a negative impact on the patient's clinical situation. The aim of this study is to establish the prevalence of clinically significant depressive symptomatology in patients with a diagnosis of heart failure seen in an outpatient clinic in Bucaramanga between May and December 2021. An observational, descriptive, cross-sectional, descriptive study was carried out to evaluate the frequency and distribution of clinically important depressive symptoms in patients with a diagnosis of heart failure using the PHQ-9, and to explore their association with psychosocial variables such as perceived social support and quality of life using the social support questionnaire (MOS) and the Minnesota Living with Heart Failure Questionnaire (MLHFQ), respectively. A total of 153 patients over 18 years of age were included, of whom 65.4% were male, finding that 17% of the population presented depressive symptoms of clinical importance. The relationship between PHQ-9 and social support is negative, which means that it is inversely proportional to higher perceived social support, lower score on the PHQ-9 (P=0.179). A highly significant correlation was found between the PHQ-9 and quality of life, the greater the impact of heart failure on quality of life, the greater the score of clinically important depressive symptoms (P<0.001).EspecializaciónEspecialista en Medicina FamiliarIntroducción 16 Planteamiento Del Problema 17 Justificación 22 Objetivos 26 Objetivo General 26 Objetivos Específicos 26 Marco Referencial 27 Metodología 48 Consideraciones Bioéticas 54 Resultados 57 Discusión 70 Conclusiones 75 Recomendaciones 76 Referencias Bibliográficas 77 Apéndices 8998 papplication/pdfUniversidad de SantanderT 63.23 V173pRepositorio Digital Universidad de Santanderhttps://repositorio.udes.edu.cohttps://repositorio.udes.edu.co/handle/001/8058spaUniversidad de SantanderBucaramangaFacultad Ciencias Médicas y de la SaludBucaramanga, ColombiaEspecialización en Medicina FamiliarZiaeian B, Fonarow GC. Epidemiology and aetiology of heart failure. Nat Rev Cardiol 2016; 13: 368 – 78.Carels, R. A. The association between disease severity, functional status, depression and daily quality of life in congestive heart failure patients. Quality of Life Research 2004; 13(1), 63–72.Pintor L. Insuficiencia cardiaca y enfermedad depresiva, una frecuente combinación tantas veces olvidada. Revista Española de Cardiología 2006; 761-765.Kupfer DJ. Longterm treatment of depression. London: John Wiley & Sons LTD; 1992b. p. 33-52.Gottlieb SS, Khatta M, Friedmann E, Einbinder L, Katzen S, Baker B, et al. The influence of age, gender, and race on the prevalence of depression in heart failure patients. J Am Coll Cardiol. 2004;43(9):1542-9.Pihl E, Jacobsson, Fridlund B, Stromberg A, Martensson J. Depression and health-related quality of life in elderly patients suffering from heart failure and their spouses: a comparative study. Europe Heart Failure 2005; 7(4): 583-9.Grupo de trabajo de la Guía de Práctica Clínica sobre el Manejo de la Depresión en el Adulto. Guía de Práctica Clínica sobre el Manejo de la Depresión en el Adulto. Ministerio de Sanidad, Servicios Sociales e Igualdad. Agencia de Evaluación de Tecnologías Sanitarias de Galicia (avalia-t); 2014; Guías de Práctica Clínica en el SNS: Avalia-t 2013/06.Aloisi G, Zucchelli A, Aloisi B, Romanelli G, Marengoni A. Depression and heart failure: an intricate relationship. Monaldi Arch Chest Dis. 2019; 11;89.Camacho TC, Roberts RE, Lazarus NB, Kaplan GA, Cohen RD. Physical activity and depression: evidence from the Alameda County Study. Am J Epidemiol 1991; 134: 220-31.Koenig HG. Depression in hospitalized older patients with congestive heart failure. Gen Hosp Psychiatry. 1998; 20(1):29–43.Szyguła-Jurkiewicz B, Zakliczynski M, Owczarek A, Partyka R, Moscinski M, Pudlo R, et al. Low health-related quality of life is a predictor of major adverse cardiovascular events in patients with chronic non ischemic Heart Failure. Kardiochir Torakochirurgia Pol. 2014;11:283.Achury-Saldaña, DM. Autocuidado y adherencia en pacientes con falla cardiaca. Aquichan 2007 Oct; 7(2): 139-160.Orso F, Fabbri G, Maggioni AP. Epidemiology of heart failure. Handb Exp Pharmacol 2017; 243: 15 – 33.Heidenreich PA, Albert NM, Allen LA, Bluemke DA, Butler J, Fonarow GC, Ikonomidis JS, Khavjou O, Konstam MA, Maddox TM, Nichol G, Pham M, Piña IL, Trogdon JG. Forecasting the impact of heart failure in the United States: a policy statement from the American Heart Association. Circ Heart Fail (2013) 6:606–619.De la Fuente-Cid R, Hermida-Ameijeiras A, Pazo-Núñez M, Lado-Lado F. Epidemiología de la insuficiencia cardiaca. An Med Interna (Madrid) 2007; 24: 500-504.Gómez E. Introducción, epidemiología de la falla cardiaca e historia de las clínicas de falla cardiaca en Colombia. Revista Colombiana de Cardiología, 2016; ISSN: 0120-5633, Vol: 23, Page: 6-12.Ospina AV, Gamarra G. Características clínicas y epidemiológicas de la insuficiencia cardiaca en el Hospital Universitario Ramón González Valencia de Bucaramanga, Colombia. Salud UIS. 2004; 36:125-31.Malhi GS, Mann JJ. Depression. Lancet. 2018 nov 24;392(10161):2299-2312.Moudgil R, Haddad H. Depression in heart failure. Curr Opin Cardiol. 2013;28(2):249-58.Mbakwem A, Aina F, Amadi C. Expert Opinion-Depression in Patients with Heart Failure: ¿Is Enough Being Done? Cardiac failure review, 2016;2(2), 110–112.Johansson P, Dahlstrom U, Brostrom A. Consequences and predictors of depression in patients with chronic heart failure: implications for nursing care and future research. Progress in cardiovascular nursing. 2006;21(4):202-11.Sin MK. Personal characteristics predictive of depressive symptoms in Hispanics with heart failure. Issues Ment Health Nurs. 2012;33(8):522-7.Graven L. J, Martorella G, Gordon G, Grant JS, Higgins MK. Predictors of depression in outpatients with heart failure: An observational study. International journal of nursing studies. 2017; 69, 57–65.Eisele M, Harder M, Rakebrandt A, Boczor S, Marx G, Blozik E, Träder JM, Störk S, Herrmann-Lingen C, Scherer M. Association of depression and anxiety with adherence in primary care patients with heart failure-cross-sectional results of the observational RECODE-HF cohort study [published online ahead of print. Fam Pract. 2020; 37(5):695-702.Van der Wal MH, Jaarsma T. Adherence in heart failure in the elderly: problem and possible solutions. Int J Cardiol. 2008;125(2):203-8.Casey E, Hughes JW, Waechter D, Josephson R, Rosneck J. Depression predicts failure to complete phase-II cardiac rehabilitation. Journal of behavioral medicine. 2008;31(5):421-31.Bauer LK, Caro MA, Beach SR, Mastromauro CA, Lenihan E, Januzzi JL, Huffman JC. Effects of depression and anxiety improvement on adherence to medication and health behaviors in recently hospitalized cardiac patients. Am J Cardiol. 2012;109(9):1266-71.Jünger J, Schellberg D, Müller-Tasch T, Raupp G, Zugck C, Haunstetter A, Zipfel S, Herzog W, Haass M. Depression increasingly predicts mortality in the course of congestive heart failure. Eur J Heart Fail. 2005;7(2):261-7.Grippo AJ, Johnson AK. Stress, depression and cardiovascular dysregulation: a review of neurobiological mechanisms and the integration of research from preclinical disease models. Stress. 2009;12(1):1-21.Jiménez JA, Peterson CT, Mills PJ. Neuroimmune Mechanisms of Depression in Adults with Heart Failure. Methods Mol Biol. 2018; 1781:145-169.Liu RH, Pan JQ, Tang XE, Li B, Liu SF, Ma WL. The role of immune abnormality in depression and cardiovascular disease. J Geriatr Cardiol. 2017;14(11):703-710.Guidi J, Offidani E, Rafanelli C, Roncuzzi R, Sonino N, Fava GA. The assessment of allostatic overload in patients with congestive heart failure by clinimetric criteria. Stress and Health. 2016 feb;32(1):63-9.Lane DA, Chong AY, Lip GYH. Psychological interventions for depression in heart failure. Cochrane Database of Systematic Reviews 2005; Issue 1. Art. No.: CD003329Gnanasekaran G. Epidemiology of depression in heart failure. Heart Fail Clin. 2011;7(1):1-10.Joynt KE, Whellan DJ, O'connor CM. Why is depression bad for the failing heart? A review of the mechanistic relationship between depression and heart failure. J Card Fail. 2004;10(3):258-71.Mastrogiannis D, Giamouzis G, Dardiotis E, Karayannis G, Chroub-Papavaiou A, Kremeti D, Spiliopoulos K, Georgoulias P, Koutsias S, Bonotis K, Mantzorou M, Skoularigis J, Hadjigeorgiou GM, Butler J, Triposkiadis F. Depression in patients with cardiovascular disease. Cardiology research and practice. 2012; 2012:794762.Cassiani-Miranda, C., Cuadros-Cruz, K., Torres Pinzón, H., Scoppetta, O., Pinzón-Tarrazona, J., López-Fuentes, W., 2019. Validez del Cuestionario de Salud del Paciente-9 (PHQ-9) para cribado de depresión en adultos usuarios de atención primaria en Bucaramanga, Colombia. Revista Colombiana de Psiquiatría. 2020.Celano CM, Villegas AC, Albanese AM, Gaggin HK, Huffman JC. Depression and Anxiety in Heart Failure: A Review. Harv Rev Psychiatry. 2018;26(4):175-184.Montes Pena F, Amorim A, Fassbender C, De Oliveira RF, Cardozo C. Insuficiencia cardíaca y depresión. Revista Insuficiencia Cardiaca. Insuf Card 2011;(Vol 6) 4:179-187.Dhar AK., Barton DA. (2016). Depression and the Link with Cardiovascular Disease. Frontiers in psychiatry. 2016; Vol 7, 33.Y. Shimizu S. Yamada F, Miyake F, Izumi T. The effects of depression on the course of functional limitations in patients with chronic heart failure. Journal of Cardiac Failure, 2011; vol. 17, no. 6, pp. 503–510.Moraska AR, Chamberlain AM, Shah ND, Vickers KS, Rummans TA, Dunlay SM, Spertus JA, Weston SA, McNallan SM, Redfield MM, Roger VL. Depression, healthcare utilization, and death in heart failure: a community study. Circ Heart Fail. 2013 May;6(3):387-94.Rodríguez J, Pastor M. Afrontamiento, apoyo social, calidad de vida y enfermedad. Psicothema. 1993, Vol 5 (Supl. 1), 349-372.Cassel, J. La contribución del entorno social a la resistencia del anfitrión. Revista Estadounidense de Epidemiología. 1976; 104, 107-123.Chung ML, Lennie TA, Dekker RL, Wu J R, Moser DK. Depressive symptoms and poor social support have a synergistic effect on event-free survival in patients with heart failure. Heart & lung: the journal of critical care, 2011; 40 (6), 492–501.Chung ML, Moser DK, Lennie TA, Frazier SK. Perceived social support predicted quality of life in patients with heart failure, but the effect is mediated by depressive symptoms. Quality of life research: an international journal of quality of life aspects of treatment, care and rehabilitation, 2013; 22 (7), 1555–1563).Schwartzmann L. Calidad de vida relacionada con la salud: aspectos conceptuales. Ciencia y enfermería. Diciembre de 2003;9(2).Coelho R, Ramos S, Prata J, Bettencourt P, Ferreira A. Heart failure and health related quality of life. Clinical Practice of Epidemiology Mental Health 2005; 1: 19.Alla F, Briançon S, Guillemin F, Juillière Y, Mertès PM, Villemot JP. Self-rating of quality of life provides additional prognostic information in heart failure. Insights into the EPICAL study. European Journal of Heart Failure, (2002)4(3), 337–343.Luskin F, Reitz M, Newell K, Quinn T, Haskell W. A controlled pilot study of stress management training of elderly patients with congestive heart failure. Prev Cardiol 2002; 5: 168-172.Smith L. Evaluation and treatment of depression in patients with heart failure. J Am Acad Nurse Pract. 2010;22(8):440-448.Saveanu RV, Mayes T. Diagnosing depression in congestive heart failure. Heart Fail Clin. 2011;7(1):75-79.Delville CL, McDougall G. A systematic review of depression in adults with heart failure: instruments and incidence. Issues Ment Health Nurs. 2008;29(9):1002-17.Maixner SM, Struble L, Blazek M, Kales HC. Later-life depression and heart failure. Heart Fail Clin. 2011;7(1):47-58.Chung ML, Moser DK, Lennie TA, Rayens MK. The effects of depressive symptoms and anxiety on quality of life in patients with heart failure and their spouses: testing dyadic dynamics using Actor-Partner Interdependence Model. Journal of psychosomatic research. 2009;67(1):39-5.Friedman B, Lyness JM, Delavan RL, Chunyu L, Barker WH. Major depression and disability in older primary care patients with heart failure. Journal of geriatric psychiatry and neurology. 2008;21(2):111-22.Patron E, Messerotti Benvenuti S, Lopriore V, Aratari J, Palomba D. Somatic-Affective, but not cognitive-depressive symptoms are associated with reduced health–related quality of life in patients with congestive heart failure. Psychosomatics. Mayo de 2017;58(3):281-91.Skotzko CE. Symptom perception in CHF: (why mind matters). Heart Fail Rev. 2009;14(1):29-34.Bellon, JA. Delgado A. Validez y fiabilidad del cuestionario de apoyo social funcional Duke-UNC-11. Sociedad Española de Medicina de Familia y Comunitaria. Atención Primaria, 1996; vol. 18, número 4, pp: 153-163.Sánchez-Ropero EM, Vera-Giraldo CY, Navas-Ríos CM, Ortiz-Rangel SD, Rodríguez-Guevara C, Vargas-Montoya DM, Aguirre-Acevedo DC, Lugo-Agudelo LH. Validación para Colombia del cuestionario para la “Medición de la capacidad funcional en pacientes con falla cardíaca”. Revista Colombiana de Cardiología. 2018 ;25(6):356-65.Lugo-Agudelo LH, Ortiz-Rangel SD, Rodríguez-Guevara C, Vargas-Montoya DM, Aguirre-Acevedo DC, Vera-Giraldo CY, Navas-Ríos CM. Validación del Minnesota Living with Heart Failure questionnaire (MLFHQ) en pacientes con falla cardíaca. Revista Colombiana de Cardiología. 2020 ;27(6):564-72.Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40(5):373-383.Charlson ME, Charlson RE, Peterson JC, Marinopoulos SS, Briggs WM, Hollenberg JP. The Charlson comorbidity index is adapted to predict costs of chronic disease in primary care patients. J Clin Epidemiol. 2008;61(12):1234-1240.Suarez-Cuba M. identificación y utilidad de las herramientas para evaluar el apoyo social al paciente y al cuidador informal. Revista Médica La Paz, 2011; 17(1), 60-67.Londoño N, Rogers H. Validación en Colombia del cuestionario MOS de apoyo social International Journal of Psychological Research, 2012; vol. 5, núm. 1, pp. 142-150.Barrón-Lopez A. Fuertes FC. Apoyo social percibido: su efecto protector frente a los acontecimientos vitales estresantes. Revista de Psicología Social, 1992; 7 (1). pp. 53-59.Murberg TA, Bru E, Aarsland T, Svebak S. Social support, social disability and their role as predictors of depression among patients with congestive heart failure. Scand J Soc Med. 1998;26(2):87–95.Artinian NT, Artinian CG, Saunders MM. Identifying and Treating Depression in Patients With Heart Failure. The Journal of Cardiovascular Nursing, 2004; 19, S47–S56.Riegel B, Carlson B. Is individual peer support a promising intervention for persons with heart failure? Journal of Cardiovascular Nursing, 2004; 19(3), 174–183.Dunbar SB, Clark PC, Deaton C, Smith AL, De AK, O’Brien M. C. Family education and support interventions in heart failure: A pilot study. Nursing Research, 2005; 54(3), 158–166.Ponikowski P, Voors AA. ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the special contribution of th. 2016; 18:891–975.Butler J, Fonarow GC, Zile MR, Lam CS, Roessig L, Schelbert EB, Shah SJ , Bonow RO, Cleland JGF, Cody RJ, Chioncel O, Collins SP, Dunnmon P FG, Lefkowitz MP, Marti CN, McMurray JJ, Misselwitz F, Nodari S, O’Connor C P, MA, Pieske B, Pitt B, Rosano G, Sabbah HN, Senni M, Solomon SD SN, Teerlink JR, Georgiopoulou VV GM. Developing therapies for heart failure with preserved ejection fraction: current state and future directions. JACC. Hear Fail. 2014; 2:97–112.Dávila-Spinetti D, Donis H, Jose H, González M, Sánchez F. Fisiopatología, diagnóstico y tratamiento médico de la insuficiencia cardiaca congestiva. Revista Venezolana de Endocrinología y Metabolismo. 2010; 8(3), 88-98.Failure H, Hfa A, Esc D, Miembros A, Piotr DT, Presidente P, et al. Guía ESC 2016 sobre el diagnóstico y tratamiento de la insuficiencia cardiaca aguda y crónica Grupo de Trabajo de la Sociedad Europea de Cardiología de diagnóstico y tratamiento. 2017;69.McCullough PA, Philbin EF, Spertus JA, Kaatz S, Sandberg KR, Weaver WD. Confirmation of a heart failure epidemic: findings from the Resource Utilization Among Congestive Heart Failure (REACH) study.J Am Coll Cardiol. 2002; 39:60-69.Speranza-Sánchez M, Adames A, Benavides A, Paulino A, González B, Umaña CD, Chaves D,Quesada, Rodríguez I B, Chaves G, Barquero JP, García LR, Bulnes JM, Mendoza M, Fausto SR, Correa L, Iglesias RM. Primer Consenso Centroamericano y El Caribe de Sociedades de Cardiología para el diagnóstico y manejo de la Falla Cardíaca. Revista Costarricense de Cardiología. 2015; 17(1-2), 5-49.Kelder JC, Cramer MJ, van Wijngaarden J, van Tooren R, Mosterd A, Moons KG, et al. The diagnostic value of physical examination and additional testing in primary care patients with suspected heart failure. Circulation. 2011;124(25):2865-73.McKee PA, Castelli WP, McNamara PM, Kannel WB. The natural history of congestive heart failure: the Framingham study. The New England journal of medicine. 1971;285(26):1441-6.Goldman L, Hashimoto B, Cook EF, Loscalzo A. Comparative reproducibility and validity of systems for assessing cardiovascular functional class: advantages of a new specific activity scale. Circulation. 1981 Dec;64(6):1227-34.Schulz PE, Arora G. Depression. Continuum (Minneap Minn). Behavioral Neurology and Neuropsychiatry. 2015; 21(3):756-71.Pérez-Padilla, EA. Cervantes-Ramírez, VM. Hijuelos-García, NA. Pineda-Cortés, JC. Salgado-Burgos, H. Prevalencia, causas y tratamiento de la depresión Mayor. Revista biomédica. 2017; 28(2), 73-98.Organización Mundial de la Salud, OMS, disponible en: https://www.who.int/es/news-room/fact-sheets/detail/depression.Andrade L, Caraveo-Anduaga JJ, Berglund P, Bijl RV, De Graaf R, Vollebergh W, et al. The epidemiology of major depressive episodes: results from the International Consortium of Psychiatric Epidemiology (ICPE) Surveys. Int J Methods Psychiatr Res 2003; 12: 3-21.American Psychiatric Association. DSM-5. Manual Diagnóstico y Estadístico de los Trastornos Mentales.DSM-5®. Edición: 5ª. Editorial Médica Panamericana. 2014; 492 pp.Organización Panamericana de la Salud. Clasificación estadística internacional de las enfermedades y problemas relacionados con la salud (CIE-10). Washington, D.C: OPS; 1995.Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. Journal of general internal medicine. 2001;16(9):606-13.Kocalevent RD, Hinz A, Brahler E. Standardization of the depression screener patient health questionnaire (PHQ-9) in the general population. Gen Hosp Psychiatry. 2013;35(5):551-5.Williams JW, Jr., Pignone M, Ramirez G, Perez Stellato C. Identifying depression in primary care: a literature synthesis of case-finding instruments. Gen Hosp Psychiatry. 2002;24(4):225-37.Dickstein K, Cohen-Solal A, Filippatos G et al.ESC Guidelines for the diagnosis andtreatment of acute and chronic heart failure 2008: the Task Force for the Diagnosisand Treatment of Acute and Chronic Heart Failure 2008 of the European Society ofCardiology. Developed in collaboration with the Heart Failure Association of the ESC(HFA) and endorsed by the European Society of Intensive Care Medicine (ESICM). Eur Heart J. 2008; 29:2388-2442.Kop WJ, Synowski SJ, Gottlieb SS. Depression in heart failure: biobehavioral mechanisms. Heart Fail Clin. 2011;7(1):23-38.Luttik ML, Jaarsma T, Moser D, Sanderman R, van Veldhuisen DJ. The importance and impact of social support on outcomes in patients with heart failure: an overview of the literature. The Journal of cardiovascular nursing, 2005; 20(3), 162–169.Krumholz HM, Butler J, Miller J, Vaccarino V, Williams CS, Mendes de Leon CF, Seeman TE, Kasl SV, Berkman LF. Prognostic importance of emotional support for elderly patients hospitalized with heart failure. 1998;97(10):958-64.House JS, Umberson D, Landis KR. Structures and processes of social support. Ann Rev Sociol. 1988;14:293–318.Suarez Cuba MA. Identificación y utilidad de las herramientas para evaluar el apoyo social al paciente y al cuidador informal. Rev. Méd. La Paz. 2011; 17 (1): 60-67.Matud P, Caballeira M, López M, Marrero R, Ibáñez I. Apoyo social y salud: un análisis de género. Salud Mental 2002;25(2):32-37.López M, Orueta M, Gómez S, Sánchez A, Carmona J, Alonso F. El rol del cuidador de personas dependientes y sus repercusiones sobre su calidad de vida y salud. REV CLIN MED FAM 2009; 2(7):332-334.Pinto C, Lara R, Espinoza E, Montoya P. Propiedades psicométricas de la escala de apoyo social percibido de Zimet en personas mayores de Atención Primaria de Salud. 2014; 23(1-2): 85-89.Terol M, López S, Neipp M, Rodríguez J, Pastor MA, Martín-Arago, M. Apoyo social e instrumentos de evaluación: revisión y clasificación. Anuario de psicología/The UB Journal of psychology, 2004; 35(1), 23–46.Martín-Carbonell M, Cerquera-Córdoba A, Fernández-Daza M, Higuita JD, Galván G, Guerrero M, Riquelme A. Estructura factorial del Cuestionario de Apoyo Social MOS en ancianos colombianos con dolor crónico. Terapia psicológica, (2019)37(3), 211-224.Vivaldi F. Barra E. Bienestar Psicológico, Apoyo Social Percibido y Percepción de Salud en Adultos Mayores. Terapia psicológica, 2012; 30(2), 23-29.Friedmann E, Son H, Thomas SA, Chapa DW, Lee HJ. Poor social support is associated with increases in depression but not anxiety over 2 years in heart failure outpatients. The Journal of cardiovascular nursing, 2014; 29(1), 20–28.Alvarado B, Zunzunegui M, Béland F, Bamvita J. Life course social and health conditions linked to frailty in Latin American older men and women. Journals of Gerontology: Medical Sciences, 2008; 63, 1399-1406.Ministerio de Salud y Protección Social, Departamento Administrativo de ciencia, Tecnología e Innovación-Colciencias. Guía de práctica clínica para la prevención, diagnóstico, tratamiento y rehabilitación de la falla cardíaca en población mayor de 18 años B, C y D. Guía para profesionales de la Salud 2016).Rector TS, Kubo SH, Cohn JN. Patient’s self-assessment of their congestive heart failure: Content, reliability and validity of a new measure: The Minnesota living with heart failure questionnaire. Heart Fail. 1987; 3:198---219.Garin O, Soriano N, Ribera A, Ferrer M, Pont À, Alonso J, Permanyer G. Validación de la versión española del minnesota living with heart failure questionnaire. Revista Española de Cardiología. 2008;61(3):251-9.Jaarsma T, Lesman-Leegte I, Hillege HL, Veeger NJ, Sanderman R, van Veldhuisen DJ. Depression and the usefulness of a disease management program in heart failure: insights from the COACH (Coordinating study evaluating Outcomes of Advising and Counseling in Heart failure) study. J Am Coll Cardiol. 2010;55(17):1837Y1843.Mohd-Razali N, Bee Y. Power Comparisons of Shapiro-Wilk, Kolmogorov-Smirnov, Lilliefors & Anderson-Darling Tests. J Stat Model Anal, (2011) 2(1), 21-33. ISBN: 978-967-363-157-5.Blanco-Restrepo JH, Maya-Mejía JM, Torres de Galvis Y. No Title. In: Salud MDE, Salud ELMDE. MINISTERIO DE SALUD RESOLUCION NUMERO 8430 DE 1993. 1993;1993(octubre 4):1–19.Ortiz-Hernández L, López-Moreno S, Borges G. Desigualdad socioeconómica y salud mental: revisión de la literatura latinoamericana [Socioeconomic inequality and mental health: a Latin American literature review]. Cad Saude Publica. 2007 Jun;23(6):1255-72.Araya R, Lewis G, Rojas G, Fritsch R. Education and income: which is more important for mental health? 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