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Depression among elderly people with and without heart failure, managed in a primary healthcare setting.
Umeå University, Faculty of Medicine, Omvårdnad.
Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Medicine.
Umeå University, Faculty of Medicine, Omvårdnad.
Umeå University, Faculty of Medicine, Omvårdnad.
2008 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 22, no 3, 376-382 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND AND RESEARCH OBJECTIVES: Depression is common among patients with heart failure (HF) and among elderly in general. Problems in diagnosing and care planning can arise as symptoms of HF, dyspnoea and especially fatigue, are nonspecific and also overlap with symptoms of depression. The objective of this study was to describe the prevalence and compare degrees of depression among patients with confirmed HF, patients with symptoms similar to HF (no heart failure, NHF) and a reference group in one primary healthcare centre (PHC), after adjusting for background characteristics and fatigue. SUBJECTS AND METHODS: A descriptive case-reference study was conducted in one PHC in a middle-sized city. Participants were 49 patients with confirmed HF, 59 patients with symptoms similar to HF (NHF) and 40 people in a reference group. After informed consent data were collected by structured interviews using the Geriatric Depression Scale and the Multidimensional Fatigue Inventory-20. Odds ratios for the outcomes HF vs. NHF, HF vs. reference group, and NHF vs. reference group were calculated. RESULTS: The HF and NHF groups had similar degrees of depression which were significantly higher than for the reference group. This difference between the groups did not remain significant when adjusting for physical fatigue. More patients in the NHF than in the HF group were living alone and there were more women in the NHF than in the reference group. CONCLUSIONS: Prevalence of depression and degrees of fatigue were higher among elderly from a PHC who experienced HF symptoms, independent of objectively measured heart function, compared with elderly without such symptoms. When comparing degrees of depression between the three groups and adjusting for fatigue, the physical dimension of fatigue was of greater importance in explaining group differences.

Place, publisher, year, edition, pages
2008. Vol. 22, no 3, 376-382 p.
Identifiers
URN: urn:nbn:se:umu:diva-19057DOI: 10.1111/j.1471-6712.2007.00540.xPubMedID: 18840221OAI: oai:DiVA.org:umu-19057DiVA: diva2:201237
Available from: 2009-03-03 Created: 2009-03-03 Last updated: 2017-12-13
In thesis
1. Man måste vila emellanåt: patienters självskattade och berättade erfarenheter av att leva med kronisk hjärtsvikt
Open this publication in new window or tab >>Man måste vila emellanåt: patienters självskattade och berättade erfarenheter av att leva med kronisk hjärtsvikt
2007 (Swedish)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The overall purpose was to explore the experience of living with chronic heart failure among patients in primary healthcare. Comparisons were made between patients with confirmed heart failure (HF, n=49), patients with symptoms indicating HF but with no HF (NHF, n=59), and a reference group (n=40). The mean age was 77 years. Patients in the HF and NHF groups had more general and physical fatigue, more reduced activity, worse physical quality of life and higher degree of depression compared with the reference group. The HF group had also higher degree of physical fatigue and worse physical quality of life than the NHF group. When comparing degrees of depression between the three groups and adjusting for fatigue, the physical dimension of fatigue was of greater importance in explaining group differences. In the HF group general fatigue was more closely related to limitations in role functioning for physical reasons than to reduced physical function per se. Women experienced more fatigue than men. Narrative interviews were conducted with ten women with confirmed heart failure, aged 73-89 years, with special reference to fatigue. The findings were presented in two themes, ‘living with the loss of physical energy’, and ‘striving for independence while being aware of deteriorating health’. The conclusion in study IV was in accordance with the results in the quantitative studies, indicating that the experience of HF or symptoms similar to HF had the greatest impact on the physical dimensions of fatigue and health-related quality of life. From a clinical perspective the findings in this thesis emphasize the importance of careful investigation of each patients experienced problems. In particular symptoms of depression and different dimensions of fatigue need to be analysed. Interventions aimed at reducing fatigue needs to be developed, and its further impact on health-related quality of life should be investigated.

Place, publisher, year, edition, pages
Umeå: Omvårdnad, 2007. 60 p.
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 1113
Keyword
Nursing, Omvårdnad, kronisk hjärtsvikt, livskvalitet, fatigue, depression, äldre
Research subject
Caring Sciences
Identifiers
urn:nbn:se:umu:diva-1322 (URN)978-91-7264-366-6 (ISBN)
Public defence
2007-09-19, Aulan, Vårdvetarhuset, Umeå Universitet, 901 87 Umeå, 13:00 (English)
Opponent
Supervisors
Available from: 2007-08-31 Created: 2007-08-31 Last updated: 2009-05-19Bibliographically approved

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