Abstract

BackgroundDepressive symptoms are common in patients with cardiovascular disease (CVD) and are associated with a poorer quality of life and prognosis. Despite the high prevalence and negative consequences, the recognition of depressive symptoms is low. More knowledge about patients' perceptions of how depressive symptoms are addressed by healthcare professionals is therefore needed.ObjectivesThe aim of this study was to explore the experiences of patients with CVD of how healthcare professionals address and manage depressive symptoms in clinical cardiac care encounters.MethodsA qualitative, semistructured interview study was performed. Data were analyzed using inductive thematic analysis.ResultsIn total, 20 patients with CVD previously treated for depressive symptoms were included (mean age, 62 [range, 34–79] years; 45% women). Three main themes emerged: (1) “not being seen as a whole person,” (2) “denying depressive symptoms,” and (3) “being provided with help.” The patients perceived that healthcare professionals mainly focused on somatic symptoms and disregarded their need for help for depressive symptoms when patients raised the issue. Some patients stated that they received help for depressive symptoms, but this depended on the patients' own ability to communicate their needs and/or having social support that could alert them to the importance of doing so. Patients also described that they downplayed the burden of depressive symptoms and/or did not recognize themselves as having depressive symptoms.ConclusionDepressive symptoms were overlooked in patients with CVD, and psychological needs had not been met. A good ability to address needs and having good social support were useful for receiving help with depressive symptoms.

Highlights

  • You have been in contact with the health service and been treated for your heart disease

  • By exploring the perspective of cardiovascular disease (CVD) patients, this study aims to contribute to a better understanding of patients’ experiences regarding how health-care professionals in cardiac care address and manage depressive symptoms in a clinical context

  • Some patients felt that they were emotionally rejected by health-care professionals when they attempted to initiate a discussion about their depressive symptoms

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Summary

Introduction

You have been in contact with the health service and been treated for your heart disease. Studies have shown that CVD patients with depressive symptoms compared to those without experience poorer HRQoL, and have an increased risk of cardiovascular complications and premature death.[1,3] Both behavioral and biological mechanisms can explain these negative effects.[2] Behavioral mechanisms can include lack of treatment adherence,[4] delay in seeking hospital admission due to a worsening of CVD5 and resistance to performing necessary lifestyle changes.[2] Biologically, depressive symptoms seem to lead to an increased stress and inflammatory response,[6] which can lead to a worsening of cardiac health.[7]

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