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Cardiac Rehabilitation Patients’ Accounts of Their Emotional Distress and Psychological Needs: A Qualitative Study

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Zeitschriftentitel: Journal of the American Heart Association
Personen und Körperschaften: McPhillips, Rebecca, Salmon, Peter, Wells, Adrian, Fisher, Peter
In: Journal of the American Heart Association, 8, 2019, 11
Format: E-Article
Sprache: Englisch
veröffentlicht:
Ovid Technologies (Wolters Kluwer Health)
Schlagwörter:
Cardiology and Cardiovascular Medicine
author_facet McPhillips, Rebecca
Salmon, Peter
Wells, Adrian
Fisher, Peter
McPhillips, Rebecca
Salmon, Peter
Wells, Adrian
Fisher, Peter
author McPhillips, Rebecca
Salmon, Peter
Wells, Adrian
Fisher, Peter
spellingShingle McPhillips, Rebecca
Salmon, Peter
Wells, Adrian
Fisher, Peter
Journal of the American Heart Association
Cardiac Rehabilitation Patients’ Accounts of Their Emotional Distress and Psychological Needs: A Qualitative Study
Cardiology and Cardiovascular Medicine
author_sort mcphillips, rebecca
spelling McPhillips, Rebecca Salmon, Peter Wells, Adrian Fisher, Peter 2047-9980 Ovid Technologies (Wolters Kluwer Health) Cardiology and Cardiovascular Medicine http://dx.doi.org/10.1161/jaha.118.011117 <jats:sec xml:lang="en"> <jats:title>Background</jats:title> <jats:p xml:lang="en"> Psychological distress is prevalent among patients with cardiovascular disease and is linked to increased risk of future cardiac events. Cardiac rehabilitation ( <jats:styled-content style="fixed-case">CR</jats:styled-content> ) is widely recommended for treating psychological distress but has been of limited benefit. This study aims to understand how distressed cardiac patients describe their emotional needs and the response of <jats:styled-content style="fixed-case">CR</jats:styled-content> . </jats:p> </jats:sec> <jats:sec xml:lang="en"> <jats:title>Methods and Results</jats:title> <jats:p xml:lang="en"> A qualitative descriptive study was conducted with 46 patients who screened positively for anxiety and/or depression. Semi‐structured interviews were held, and data were analyzed using a constant comparative approach. Patients described low mood and diverse concerns, including threat of another cardiac event, restrictions on their lives, and problems unrelated to their health. Patients described worrying constantly about these concerns, worrying about their worry, and feeling that worry was uncontrollable and harmful. Patients wanted to “get back to normal” but lacked any sense of how to achieve this and were reluctant to discuss their worries with <jats:styled-content style="fixed-case">CR</jats:styled-content> staff. They hoped to recover over time, meanwhile seeking reassurance that they were responding “normally.” Patients were mostly dismissive of psychological techniques used in <jats:styled-content style="fixed-case">CR</jats:styled-content> . </jats:p> </jats:sec> <jats:sec xml:lang="en"> <jats:title>Conclusions</jats:title> <jats:p xml:lang="en"> These findings expose a conundrum. Distressed <jats:styled-content style="fixed-case">CR</jats:styled-content> patients have diverse worries but do not generally want to discuss them, so they invest hopes for feeling better in time passing and reassurance. An intervention acceptable to <jats:styled-content style="fixed-case">CR</jats:styled-content> patients would allow them to address diverse worries but without having to share the content of worries, would have “face validity,” and would address patients’ worry about worry. Metacognitive therapy is an intervention that might be suitable. </jats:p> </jats:sec> <jats:sec xml:lang="en"> <jats:title>Clinical Trial Registration</jats:title> <jats:p xml:lang="en"> <jats:styled-content style="fixed-case">URL</jats:styled-content> : <jats:ext-link xmlns:xlink="http://www.w3.org/1999/xlink" ext-link-type="uri" xlink:href="https://www.clinicaltrials.gov">https://www.clinicaltrials.gov</jats:ext-link> . Unique identifier: <jats:styled-content style="fixed-case">NCT</jats:styled-content> 02420431. </jats:p> </jats:sec> Cardiac Rehabilitation Patients’ Accounts of Their Emotional Distress and Psychological Needs: A Qualitative Study Journal of the American Heart Association
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title Cardiac Rehabilitation Patients’ Accounts of Their Emotional Distress and Psychological Needs: A Qualitative Study
title_unstemmed Cardiac Rehabilitation Patients’ Accounts of Their Emotional Distress and Psychological Needs: A Qualitative Study
title_full Cardiac Rehabilitation Patients’ Accounts of Their Emotional Distress and Psychological Needs: A Qualitative Study
title_fullStr Cardiac Rehabilitation Patients’ Accounts of Their Emotional Distress and Psychological Needs: A Qualitative Study
title_full_unstemmed Cardiac Rehabilitation Patients’ Accounts of Their Emotional Distress and Psychological Needs: A Qualitative Study
title_short Cardiac Rehabilitation Patients’ Accounts of Their Emotional Distress and Psychological Needs: A Qualitative Study
title_sort cardiac rehabilitation patients’ accounts of their emotional distress and psychological needs: a qualitative study
topic Cardiology and Cardiovascular Medicine
url http://dx.doi.org/10.1161/jaha.118.011117
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description <jats:sec xml:lang="en"> <jats:title>Background</jats:title> <jats:p xml:lang="en"> Psychological distress is prevalent among patients with cardiovascular disease and is linked to increased risk of future cardiac events. Cardiac rehabilitation ( <jats:styled-content style="fixed-case">CR</jats:styled-content> ) is widely recommended for treating psychological distress but has been of limited benefit. This study aims to understand how distressed cardiac patients describe their emotional needs and the response of <jats:styled-content style="fixed-case">CR</jats:styled-content> . </jats:p> </jats:sec> <jats:sec xml:lang="en"> <jats:title>Methods and Results</jats:title> <jats:p xml:lang="en"> A qualitative descriptive study was conducted with 46 patients who screened positively for anxiety and/or depression. Semi‐structured interviews were held, and data were analyzed using a constant comparative approach. Patients described low mood and diverse concerns, including threat of another cardiac event, restrictions on their lives, and problems unrelated to their health. Patients described worrying constantly about these concerns, worrying about their worry, and feeling that worry was uncontrollable and harmful. Patients wanted to “get back to normal” but lacked any sense of how to achieve this and were reluctant to discuss their worries with <jats:styled-content style="fixed-case">CR</jats:styled-content> staff. They hoped to recover over time, meanwhile seeking reassurance that they were responding “normally.” Patients were mostly dismissive of psychological techniques used in <jats:styled-content style="fixed-case">CR</jats:styled-content> . </jats:p> </jats:sec> <jats:sec xml:lang="en"> <jats:title>Conclusions</jats:title> <jats:p xml:lang="en"> These findings expose a conundrum. Distressed <jats:styled-content style="fixed-case">CR</jats:styled-content> patients have diverse worries but do not generally want to discuss them, so they invest hopes for feeling better in time passing and reassurance. An intervention acceptable to <jats:styled-content style="fixed-case">CR</jats:styled-content> patients would allow them to address diverse worries but without having to share the content of worries, would have “face validity,” and would address patients’ worry about worry. Metacognitive therapy is an intervention that might be suitable. </jats:p> </jats:sec> <jats:sec xml:lang="en"> <jats:title>Clinical Trial Registration</jats:title> <jats:p xml:lang="en"> <jats:styled-content style="fixed-case">URL</jats:styled-content> : <jats:ext-link xmlns:xlink="http://www.w3.org/1999/xlink" ext-link-type="uri" xlink:href="https://www.clinicaltrials.gov">https://www.clinicaltrials.gov</jats:ext-link> . Unique identifier: <jats:styled-content style="fixed-case">NCT</jats:styled-content> 02420431. </jats:p> </jats:sec>
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author McPhillips, Rebecca, Salmon, Peter, Wells, Adrian, Fisher, Peter
author_facet McPhillips, Rebecca, Salmon, Peter, Wells, Adrian, Fisher, Peter, McPhillips, Rebecca, Salmon, Peter, Wells, Adrian, Fisher, Peter
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description <jats:sec xml:lang="en"> <jats:title>Background</jats:title> <jats:p xml:lang="en"> Psychological distress is prevalent among patients with cardiovascular disease and is linked to increased risk of future cardiac events. Cardiac rehabilitation ( <jats:styled-content style="fixed-case">CR</jats:styled-content> ) is widely recommended for treating psychological distress but has been of limited benefit. This study aims to understand how distressed cardiac patients describe their emotional needs and the response of <jats:styled-content style="fixed-case">CR</jats:styled-content> . </jats:p> </jats:sec> <jats:sec xml:lang="en"> <jats:title>Methods and Results</jats:title> <jats:p xml:lang="en"> A qualitative descriptive study was conducted with 46 patients who screened positively for anxiety and/or depression. Semi‐structured interviews were held, and data were analyzed using a constant comparative approach. Patients described low mood and diverse concerns, including threat of another cardiac event, restrictions on their lives, and problems unrelated to their health. Patients described worrying constantly about these concerns, worrying about their worry, and feeling that worry was uncontrollable and harmful. Patients wanted to “get back to normal” but lacked any sense of how to achieve this and were reluctant to discuss their worries with <jats:styled-content style="fixed-case">CR</jats:styled-content> staff. They hoped to recover over time, meanwhile seeking reassurance that they were responding “normally.” Patients were mostly dismissive of psychological techniques used in <jats:styled-content style="fixed-case">CR</jats:styled-content> . </jats:p> </jats:sec> <jats:sec xml:lang="en"> <jats:title>Conclusions</jats:title> <jats:p xml:lang="en"> These findings expose a conundrum. Distressed <jats:styled-content style="fixed-case">CR</jats:styled-content> patients have diverse worries but do not generally want to discuss them, so they invest hopes for feeling better in time passing and reassurance. An intervention acceptable to <jats:styled-content style="fixed-case">CR</jats:styled-content> patients would allow them to address diverse worries but without having to share the content of worries, would have “face validity,” and would address patients’ worry about worry. Metacognitive therapy is an intervention that might be suitable. </jats:p> </jats:sec> <jats:sec xml:lang="en"> <jats:title>Clinical Trial Registration</jats:title> <jats:p xml:lang="en"> <jats:styled-content style="fixed-case">URL</jats:styled-content> : <jats:ext-link xmlns:xlink="http://www.w3.org/1999/xlink" ext-link-type="uri" xlink:href="https://www.clinicaltrials.gov">https://www.clinicaltrials.gov</jats:ext-link> . Unique identifier: <jats:styled-content style="fixed-case">NCT</jats:styled-content> 02420431. </jats:p> </jats:sec>
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spelling McPhillips, Rebecca Salmon, Peter Wells, Adrian Fisher, Peter 2047-9980 Ovid Technologies (Wolters Kluwer Health) Cardiology and Cardiovascular Medicine http://dx.doi.org/10.1161/jaha.118.011117 <jats:sec xml:lang="en"> <jats:title>Background</jats:title> <jats:p xml:lang="en"> Psychological distress is prevalent among patients with cardiovascular disease and is linked to increased risk of future cardiac events. Cardiac rehabilitation ( <jats:styled-content style="fixed-case">CR</jats:styled-content> ) is widely recommended for treating psychological distress but has been of limited benefit. This study aims to understand how distressed cardiac patients describe their emotional needs and the response of <jats:styled-content style="fixed-case">CR</jats:styled-content> . </jats:p> </jats:sec> <jats:sec xml:lang="en"> <jats:title>Methods and Results</jats:title> <jats:p xml:lang="en"> A qualitative descriptive study was conducted with 46 patients who screened positively for anxiety and/or depression. Semi‐structured interviews were held, and data were analyzed using a constant comparative approach. Patients described low mood and diverse concerns, including threat of another cardiac event, restrictions on their lives, and problems unrelated to their health. Patients described worrying constantly about these concerns, worrying about their worry, and feeling that worry was uncontrollable and harmful. Patients wanted to “get back to normal” but lacked any sense of how to achieve this and were reluctant to discuss their worries with <jats:styled-content style="fixed-case">CR</jats:styled-content> staff. They hoped to recover over time, meanwhile seeking reassurance that they were responding “normally.” Patients were mostly dismissive of psychological techniques used in <jats:styled-content style="fixed-case">CR</jats:styled-content> . </jats:p> </jats:sec> <jats:sec xml:lang="en"> <jats:title>Conclusions</jats:title> <jats:p xml:lang="en"> These findings expose a conundrum. Distressed <jats:styled-content style="fixed-case">CR</jats:styled-content> patients have diverse worries but do not generally want to discuss them, so they invest hopes for feeling better in time passing and reassurance. An intervention acceptable to <jats:styled-content style="fixed-case">CR</jats:styled-content> patients would allow them to address diverse worries but without having to share the content of worries, would have “face validity,” and would address patients’ worry about worry. Metacognitive therapy is an intervention that might be suitable. </jats:p> </jats:sec> <jats:sec xml:lang="en"> <jats:title>Clinical Trial Registration</jats:title> <jats:p xml:lang="en"> <jats:styled-content style="fixed-case">URL</jats:styled-content> : <jats:ext-link xmlns:xlink="http://www.w3.org/1999/xlink" ext-link-type="uri" xlink:href="https://www.clinicaltrials.gov">https://www.clinicaltrials.gov</jats:ext-link> . Unique identifier: <jats:styled-content style="fixed-case">NCT</jats:styled-content> 02420431. </jats:p> </jats:sec> Cardiac Rehabilitation Patients’ Accounts of Their Emotional Distress and Psychological Needs: A Qualitative Study Journal of the American Heart Association
spellingShingle McPhillips, Rebecca, Salmon, Peter, Wells, Adrian, Fisher, Peter, Journal of the American Heart Association, Cardiac Rehabilitation Patients’ Accounts of Their Emotional Distress and Psychological Needs: A Qualitative Study, Cardiology and Cardiovascular Medicine
title Cardiac Rehabilitation Patients’ Accounts of Their Emotional Distress and Psychological Needs: A Qualitative Study
title_full Cardiac Rehabilitation Patients’ Accounts of Their Emotional Distress and Psychological Needs: A Qualitative Study
title_fullStr Cardiac Rehabilitation Patients’ Accounts of Their Emotional Distress and Psychological Needs: A Qualitative Study
title_full_unstemmed Cardiac Rehabilitation Patients’ Accounts of Their Emotional Distress and Psychological Needs: A Qualitative Study
title_short Cardiac Rehabilitation Patients’ Accounts of Their Emotional Distress and Psychological Needs: A Qualitative Study
title_sort cardiac rehabilitation patients’ accounts of their emotional distress and psychological needs: a qualitative study
title_unstemmed Cardiac Rehabilitation Patients’ Accounts of Their Emotional Distress and Psychological Needs: A Qualitative Study
topic Cardiology and Cardiovascular Medicine
url http://dx.doi.org/10.1161/jaha.118.011117