How Healthcare Professionals in Cardiac Care Address Depressive Symptoms: Experiences of Patients With Cardiovascular Disease

J Cardiovasc Nurs. 2020 Feb 21;36(4):340-348. doi: 10.1097/JCN.0000000000000669. Online ahead of print.

Abstract

Background: Depressive 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.

Objectives: The 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.

Methods: A qualitative, semistructured interview study was performed. Data were analyzed using inductive thematic analysis.

Results: In 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.

Conclusion: Depressive 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.