PURPOSE: To identify parsimonious models for changes in depression in spouses of post myocardial infarction (MI) patients over 2 years based on the biopsychosocial model. METHODS: A total of 442 community living patients who had experienced an MI and their spouses were included for analysis. Patients and spouses completed psychosocial assessments at baseline, 1 year, and 2 years after enrollment in the Patients' and Families' Psychological Response to Home Automated External Defibrillator Trial. Linear mixed models were used for testing hypotheses. RESULTS: A total of 15.2% (baseline), 11.5% (1-year follow up), and 8.1% (2-year follow up) of spouses were depressed. Spouse biological factors did not influence changes in depression. Amongall spouses, twogroups of spouses showed increased depression over time: spouses with lower baseline depression scores (p < .001), and spouses of patients who had higher baseline depression scores (p = .001). Among psychologically distressed (anxious or depressed) spouses, three groups of spouses showed increased depression over time: spouses who had lower baseline depression scores (p < .001), spouses who had more social support at baseline (p = .023), and spouses of patientswho had higher baseline depression scores (p < .001). CONCLUSION: Spouse and patient baseline depression significantly predicted changes in depression for all spouses and psychologically distressed spouses. Among psychologically distressed spouses, higher baseline social support predicted higher depression scores over time. This study is an important step in understanding longitudinal changes in the psychological status of spouses of MI patients for evaluating the need for interventions. It is crucial that patient couples' psychosocial factors are continuously assessed.
Biological Factors ; Defibrillators ; Depression ; Humans ; Myocardial Infarction ; Spouses

PURPOSE: The purpose of this study was to investigate the reality, status of clinical nurses' emotional labor and the relationship with physical discomfort, burnout, depression and social support. METHODS: A thousand three hundred sixteen clinical nurses from 42 hospitals nationwide participated in this study. Questionnaires were developed for evaluating the reality and status of emotional labor of clinical nurses after interviewing focus groups and reviewing literatures. Data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation coefficient. RESULTS: Ninety eight percent of nurses had answered having emotional labor and they experienced 82 times per year, 9.6 times during last a month which means they experience it every other day. The one who provoke emotional labor were patients, guardians, physicians, supervisor, and colleagues in sequence. Eighty percent of nurses had intention to leave their jobs after experiencing emotional labor. They were doing more surface acting than deep acting of emotional labor. CONCLUSION: Clinical nurses in Korea experienced excessively high level of emotional labor and delayed responding to clients' requests due to lack of time for caring each patient was revealed as one of the main causes of emotional labor.
Depression ; Focus Groups ; Humans ; Intention ; Korea