Journal article
Identifying critical psychotherapy targets in serious cardiac conditions: The importance of addressing coping with symptoms, healthcare navigation, and social support
Palliative & supportive care, Vol.17(5), pp.531-535
10/01/2019
DOI: 10.1017/S1478951518001037
PMCID: PMC9440473
PMID: 30702055
Abstract
ObjectiveIn seriously ill cardiac patients, several psychotherapy efficacy studies demonstrate little to no reduction in depression or improvement in quality of life, and little is known about how to improve psychotherapies to best address the range of patient needs. An interpersonal and behavioral activation psychotherapy was a key component of the Collaborative Care to Alleviate Symptoms and Adjust to Illness (CASA) multisite randomized clinical trial. Although depressive symptoms did improve in the CASA trial, questions remain about how best to tailor psychotherapies to the needs of seriously ill patient populations. The study objective was to describe psychosocial needs emerging during a clinical trial of a palliative care and interpersonal and behavioral activation psychotherapy intervention that were not specifically addressed by the psychotherapy.MethodDuring the CASA trial, patient needs were prospectively tracked by the psychotherapist in each visit note using an a priori code list. Preplanned analysis of study data using directed content analysis was conducted analyzing the a priori code list, which were collapsed by team consensus into larger themes. The frequency of each code and theme were calculated into a percentage of visits.ResultA total of 150 patients received one or more visits from the therapist and were included in the analysis. Participants screened positive for depressive disorder (47%), had poor heart failure-specific health status (mean Kansas City Cardiomyopathy Questionnaire score = 48.6; SD = 17.4), and multiple comorbidities (median 4.3). Common needs that emerged during the therapy included difficulty coping with fatigue (48%), pain (28%), and satisfaction issues with medical care (43%). The following broader themes emerged: social support (77% of sessions), unmet symptom needs (67%), healthcare navigation (48%), housing, legal, safety, and transportation (32%), and end of life (12%).Significance of resultsCoping with chronic symptoms and case management needs commonly emerged during psychotherapy visits. Future psychotherapy interventions in seriously ill populations should consider the importance of coping with chronic symptoms and case management.
Details
- Title: Subtitle
- Identifying critical psychotherapy targets in serious cardiac conditions: The importance of addressing coping with symptoms, healthcare navigation, and social support
- Creators
- David B. Bekelman - University of Colorado Anschutz Medical CampusChristopher E. Knoepke - University of Colorado DenverCarolyn Turvey - Iowa City VA Health Care System
- Resource Type
- Journal article
- Publication Details
- Palliative & supportive care, Vol.17(5), pp.531-535
- DOI
- 10.1017/S1478951518001037
- PMID
- 30702055
- PMCID
- PMC9440473
- NLM abbreviation
- Palliat Support Care
- ISSN
- 1478-9515
- eISSN
- 1478-9523
- Publisher
- Cambridge Univ Press
- Number of pages
- 5
- Grant note
- UL1TR001082 / NATIONAL CENTER FOR ADVANCING TRANSLATIONAL SCIENCES; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Center for Advancing Translational Sciences (NCATS) CDA 08-022 / VA HSRD NIH R01-013422 / National Institute of Nursing Research; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Nursing Research (NINR) UL1 TR001082 / NIH/NCATS Colorado CTSA; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Center for Advancing Translational Sciences (NCATS)
- Language
- English
- Date published
- 10/01/2019
- Academic Unit
- Psychiatry; Epidemiology
- Record Identifier
- 9984281651302771
Metrics
9 Record Views