THE INTERRELATIONSHIP BETWEEN INFLAMMATORY BIOMARKERS, DEPRESSIVE SYMPTOMS, AND MINDFULNESS-BASED NURSING CARE IN ACUTE CARDIAC ADMISSIONS: A PROSPECTIVE STUDY

Abstract

Acute cardiac hospitalization is frequently accompanied by psychological distress and heightened systemic inflammation, both of which may adversely influence clinical recovery. This study evaluated the interrelationship between inflammatory biomarkers, depressive symptoms, and mindfulness-based nursing care using a prospective dataset comprising 600 patients with acute cardiac conditions. Participants received either mindfulness-based nursing care or standard nursing care during hospitalization. Clinical, inflammatory, and psychological outcomes were assessed using high-sensitivity C reactive protein (hs-CRP), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), neutrophil-to-lymphocyte ratio (NLR), Patient Health Questionnaire-9 (PHQ-9), Hospital Anxiety and Depression Scale-Anxiety (HADS-A), and the Mindful Attention Awareness Scale (MAAS). Group comparisons, correlation analysis, and multiple linear regression were performed to evaluate intervention effects and identify predictors of recovery. Patients receiving mindfulness-based nursing care demonstrated significantly greater reductions in inflammatory biomarkers, depressive symptoms, and anxiety, together with greater improvements in mindfulness than those receiving standard nursing care (all p < 0.01). Higher admission hs-CRP, IL-6, and depressive symptom scores independently predicted poorer recovery outcomes, whereas greater baseline mindfulness was associated with lower depressive symptom severity at discharge. Inflammatory burden and psychological distress were also positively associated with prolonged hospitalization. These findings suggest that integrating mindfulness-based nursing interventions into acute cardiovascular care may enhance both psychological well-being and inflammatory recovery. Further validation using real-world prospective clinical cohorts is warranted to confirm the clinical applicability of these findings.