Living With Depressive Symptoms: Patients With Heart Failure

TLDR: Patients with heart failure experience symptoms of depression that are similar to those experienced by the general population, and clinicians should assess patients withHeart failure for stressors that worsen depressive symptoms.

Abstract: Background—Patients with heart failure often experience depressive symptoms that affect healthrelated quality of life, morbidity, and mortality. Researchers have not described the experience of patients with heart failure living with depressive symptoms. Understanding this experience will help in developing interventions to decrease depressive symptoms. Objective—To describe the experience of patients with heart failure living with depressive symptoms. Methods—This study was conducted by using a qualitative descriptive design. The sample consisted of 10 outpatients (50% female, mean age 63 [SD, 13] years, 70% New York Heart Association class III or IV) with heart failure who were able to describe depressive symptoms. Data were collected via taped, individual, 30- to 60-minute interviews. ATLAS ti (version 5) was used for content analysis. Results—Participants described emotional and somatic symptoms of depression. Negative thinking was present in all participants and reinforced their depressed mood. The participants experienced multiple stressors that worsened depressive symptoms. The overarching strategy for managing depressive symptoms was “taking my mind off of it.” Patients managed depressive symptoms by engaging in activities such as exercise and reading, and by using positive thinking, spirituality, and social support. Conclusions—Patients with heart failure experience symptoms of depression that are similar to those experienced by the general population. Clinicians should assess patients with heart failure for stressors that worsen depressive symptoms. Strategies that researchers and clinicians can use to reduce depressive symptoms in patients with heart failure include engaging patients in activities, positive thinking, and spirituality. Helping patients find enhanced social support may also be important. Heart failure is a chronic syndrome that affects 5 million people in the United States 1 and is the most common cause of hospitalization in elderly adults. 2 Major depressive disorder is common in hospitalized patients with heart failure. One-third of hospitalized patients with heart failure have major depression, and 40% of these persons are still depressed 1 year later. 3