Psychological Distress among Patients with Peripheral Vascular Disease: A Cross-sectional Study in Sri Lanka

Abstract

Background: Peripheral Vascular Disease (PVD) is a chonic, progrssive atherosclerotic condition characterized by patial or total occlusion of vesslels, leading to significant morbidity and limb loss. Chronic pain is often a central feature of PVD, contributing to increased anxiety, deppression and stress among affected individuals. However, psychologal burden of these patients is poorly understood in the Sri Lankan context. Objective: To assess the psychological burden of PVD in patients admitted to the vascular unit of the National Hospital of Sri Lanka (NHSL), Colombo Methods: A descriptive cross-sectional study was conducted with 213 patients aged 45-75 years. Data were collected using an interviewer-administered questionnaire. Socio-demographic characteristics were gathered and pain severity was assessed using the Numerical Pain Scale. Participants psychological distress was determined using the Depression, Anxiety and Stress Scale-21 (DASS-21) validated to Sri Lankan contex. Data were analysed using descriptive statistics and Spearman’s correlation coefficient test with SPSS version 21.0. Results: A total of 196 patients participated in the study, yeilding a response rate of 92.0% (196/213). Mean±SD of the age was 54.18±8.1. Males constituted 65.8% of the sample. The majority (87.2%) reported severe pain while, 11.2% experienced moderate pain. The vast majority of patients had moderate depression (95.9%) and moderate anxiety (94.9%). Of the sample, 8.7% reported no stress, 75.0% experienced mild stress, and 16.3% reported moderate stress. Weak positive significant correlations were found between depression and stress (r=0.186, p=0.009), anxiety and stress (r=0.145, p=0.042), and depression and anxiety (r=0.197, p=0.006). However, no significant correlations were found in depression, anxiety, and stress with pain. Conclusions: Most of the patients with PVD experence high pain intensity alongside moderate levels of depression and anxiety. There are weak but statistically significant positive correlations among depression, anxiety, and stress. This study highlights the need for implementing effective strategies for managing pain, addressing depression and anxiety, and improving coping with stress. By integrating pain management and mental health support, healthcare providers may improve patient outcomes and help reduce the burden of PVD.