Patient perspectives about depressive symptoms in heart failure: a review of the qualitative literature.
Patient perspectives about depressive symptoms in heart failure: a review of the qualitative literature.
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DOI：
10.1097/jcn.0b013e318273a5d6
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发表时间：
2014-01
期刊：
影响因子：
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通讯作者：
Dekker RL
中科院分区：
文献类型：
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作者：
Dekker RL
科学家已经系统地确定了心力衰竭(HF)患者抑郁症状的患病率和后果。然而，全面了解患者对抑郁症状的看法，结合心力衰竭，尚未发表。以患者为中心的方法可能支持设计有效的干预措施，并为患有心力衰竭和抑郁症状的患者所接受。回顾有关心力衰竭抑郁症状的致病因素、相关症状、后果和自我护理策略的患者视角的定性研究结果。定性研究包括2000至2012年间发表的英文版研究，描述了与心力衰竭生活有关的情感因素。用关键词“心力衰竭”、“质的”和“抑郁、心理社会、压力或情绪”搜索了三个电子数据库。13项研究符合纳入标准。患有心力衰竭的患者报告说，经济压力、整体健康状况不佳、既往创伤生活经历和消极思维都会导致抑郁症状。患者描述了抑郁和焦虑的认知情感症状，但没有描述抑郁的躯体症状。抑郁症状的可感知后果包括绝望、绝望、社会关系受损和参与HF自我护理的能力降低。建议的管理策略包括增强的社会支持和认知策略。心力衰竭患者的抑郁症状与许多促成因素有关，包括那些与他们的疾病无关的因素，以及降低他们自我照顾能力的严重后果。对抑郁症状的非药物管理方法，包括改善社会支持或认知干预，可能是有效和可接受的策略。
Scientists have systematically established the prevalence and consequences of depressive symptoms in patients with heart failure (HF). However, a comprehensive understanding of patient perspectives about depressive symptoms, in combination with HF, has not been published. A patient-centered approach may support the design of interventions that are effective and acceptable to patients with HF and depressive symptoms. To review qualitative findings about patient perspectives of the contributing factors, associated symptoms, consequences, and self-care strategies used for depressive symptoms in HF. Qualitative studies were included when they were published between 2000 to 2012, in English, and described emotional components about living with HF. Three electronic databases were searched using key words “heart failure,” “qualitative,” and “depression or psychosocial or stress or emotional.” Thirteen studies met inclusion criteria. Patients with HF reported that financial stressors, overall poor health, past traumatic life experiences, and negative thinking contributed to depressive symptoms. Patients described cognitive-affective symptoms of depression and anxiety, but not somatic symptoms of depression. Perceived consequences of depressive symptoms included hopelessness, despair, impaired social relationships, and a decreased ability to engage in HF self-care. Recommended management strategies consisted of enhanced social support and cognitive strategies. Depressive symptoms in patients with HF were associated with a number of contributing factors, including those not specifically related to their disease, and serious consequences that reduced their self-care ability. Non-pharmacological management approaches to depressive symptoms that include improved social support or cognitive interventions may be effective and acceptable strategies.