1. Association of psychological distress with reasons for delay in seeking medical care in rural patients with worsening heart failure symptoms
- Author
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Lin, Chin‐Yen, Dracup, Kathleen, Pelter, Michele M, Biddle, Martha J, and Moser, Debra K
- Subjects
Health Services and Systems ,Health Sciences ,Heart Disease ,Behavioral and Social Science ,Mind and Body ,Rural Health ,Depression ,Mental Health ,Cardiovascular ,Clinical Research ,Management of diseases and conditions ,7.1 Individual care needs ,Good Health and Well Being ,Anxiety ,Heart Failure ,Humans ,Patient Acceptance of Health Care ,Psychological Distress ,Surveys and Questionnaires ,anxiety ,depression ,reasons for care‐ ,seeking delay ,rural heart failure patients ,reasons for care-seeking delay ,Nursing ,Public Health and Health Services ,Public Health ,Health services and systems ,Public health ,Development studies - Abstract
BackgroundThe impact of depressive symptoms and anxiety on rural patients' decisions to seek care for worsening heart failure (HF) symptoms remains unknown. The purposes of this study were (1) to describe rural patients' reasons for delay in seeking care for HF, and (2) to determine whether depressive symptoms or anxiety was associated with patients' reasons for delay in seeking medical care for worsening symptoms.MethodsA total of 611 rural HF patients were included. Data on reasons for patient delay in seeking medical care (The Reasons for Delay Questionnaire), depressive symptoms (PHQ-9), and anxiety (BSI-ANX) were collected. Statistical analyses included chi-square and multiple regression.ResultsA total of 85.4% of patients reported at least 1 reason for delay. Patients with higher levels of depressive symptoms were more likely to cite embarrassment, problems with transportation, and financial concerns as a reason for delay. Patients with anxiety not only cited nonsymptom-related reasons but also reported symptom-related reasons for delay in seeking care (ie, symptoms seemed vague, not sure of symptoms, symptoms didn't seem to be serious enough, and symptoms were different from the last episode). In multiple regression, patients with greater depressive symptoms and anxiety had a greater number of reasons for delay in seeking care (P = .003 and P = .023, respectively).ConclusionsOur findings suggest that enhancement of patients' symptom appraisal abilities and improvement in psychological distress may result in a reduction in delay in seeking medical care for worsening symptoms in rural patients with HF.
- Published
- 2022