Background A relation to stress and stressful triggers is often, but not always, described in patients with Takotsubo syndrome. Few studies have focused on patients’ self-rated stress in combination with qualitative experiences of stress in Takotsubo syndrome. Aims The aim of this study was to describe stress before and after the onset of Takotsubo syndrome. Methods Twenty patients were recruited from five major hospitals in Stockholm, Sweden between December 2014 and November 2018. A mixed methods design was used containing the validated questionnaire, perceived stress scale (PSS-14) filled in at baseline and at a 6 and 12-month follow-up, respectively. Qualitative interviews were made at the 6-month follow-up. Results Self-rated stress, measured by the perceived stress scale, showed stress levels above the cut-off value of 25, at the onset of Takotsubo syndrome (median 30.5). Stress had decreased significantly at the 12-month follow-up (median 20.5, P = 0.039) but remained high in one third of the patients. Qualitative interviews confirmed a high long-term stress and half of the patients had an acute stress trigger before the onset of Takotsubo syndrome. The qualitative interviews showed that the patients had reflected on and tried to find ways to deal with stress, but for many this was not successful. Conclusion Patients with Takotsubo syndrome reported long-term stress sometimes with an acute stress trigger before the onset of Takotsubo syndrome. Stress decreased over time but remained high for a considerable number of patients. Despite reflection over stress and attempts to deal with stress many were still affected after 6 months. New treatment options are needed for patients with Takotsubo syndrome.

中文翻译：

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Takotsubo 综合征患者的自评压力和体验：一项混合方法研究

背景 在 Takotsubo 综合征患者中经常但不总是描述与压力和压力触发因素的关系。很少有研究将患者的自评压力与 Takotsubo 综合征的定性压力体验结合起来。目的 本研究的目的是描述 Takotsubo 综合征发作前后的压力。方法 2014 年 12 月至 2018 年 11 月期间，从瑞典斯德哥尔摩的五家主要医院招募了 20 名患者。使用混合方法设计，其中包含经过验证的问卷、在基线和 6 岁和 12 岁时填写的感知压力量表 (PSS-14)月随访，分别。在 6 个月的随访中进行了定性访谈。结果自我评估的压力，通过感知压力量表测量，显示压力水平高于 25 的临界值，在 Takotsubo 综合征发作时（中位数 30.5）。在 12 个月的随访中，压力显着下降（中位数 20.5，P = 0.039），但三分之一的患者压力仍然很高。定性访谈证实了长期的高压力，并且一半的患者在 Takotsubo 综合征发作之前有急性压力触发因素。定性访谈表明，患者已经反思并试图找到应对压力的方法，但对许多人来说，这并不成功。结论 Takotsubo 综合征患者报告长期压力，有时在 Takotsubo 综合征发作前伴有急性应激触发。压力随着时间的推移而降低，但对于相当多的患者来说仍然很高。尽管对压力进行了反思并尝试应对压力，但许多人在 6 个月后仍然受到影响。