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American Journal of Critical Care. 2006;15: 617-625
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Comparison of Anxiety Between Smokers and Nonsmokers With Acute Myocardial Infarction

By Sharon L. Sheahan, PhD, FNP, Mary K. Rayens, PhD, Kyungeh An, RN, PhD, Barbara Riegel, RN, DNSc, CS, Sharon McKinley, RN, PhD, Lynn Doering, RN, DNSc, Bonnie J. Garvin, RN, PhD and Debra K. Moser, RN, DNSc. From the University of Kentucky College of Nursing, Lexington, Ky (SLS, MKR, DKM), Acupuncture and Meridian Science Research Center, Kyung Hee University, Seoul, Korea (KA), University of Pennsylvania, Philadelphia, Pa (BR), University of Technology, Sydney and Royal North Shore Hospital, Sydney, Australia (SM), University of California, Los Angeles, Los Angeles, Calif (LD), and The Ohio State University, Columbus, Ohio (BJG).

Corresponding author: Sharon L. Sheahan, PHD, FNP, University of Kentucky, 315 College of Nursing, Lexington, KY 40536-0232 (e-mail: sharon{at}uky.edu).

• Background Increased anxiety correlates with increased complications after acute myocardial infarction. Anxiety levels and use of anxiolytic agents have not been compared between smokers and nonsmokers hospitalized because of acute myocardial infarction.

• Objectives To compare anxiety level, sociodemographic factors, and clinical variables between smokers and nonsmokers hospitalized with acute myocardial infarction and to examine predictors of use of ß-blockers and anxiolytic agents among smokers and nonsmokers.

• Methods Secondary data analysis of a prospective multisite study on anxiety in 181 smokers and 351 nonsmokers with acute myocardial infarction. Anxiety was measured by using the State Trait Anxiety Inventory and the anxiety subscale of the Basic Symptom Inventory within 72 hours of admission.

• Results Smokers reported higher anxiety levels than nonsmokers reported on both anxiety scales. Female smokers reported the highest anxiety and peak pain levels of all, yet women were the least likely to receive anxiolytic agents. Smoking status was not a predictor for anxiety level when sex, peak pain, use of ß-blockers in the hospital, and age were controlled for. However, smokers were twice as likely as nonsmokers to receive an anxiolytic agent and 60% more likely to receive a ß-blocker in the emergency department, and smokers were 80% more likely than nonsmokers to receive an anxiolytic agent during hospitalization when these variables were controlled.

• Conclusions Older female smokers are at risk for complications because they are older than their male counterparts and less likely to receive ß-blockers and antianxiety medications in the emergency department.






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Copyright © 2006 by the American Association of Critical-Care Nurses.