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How does depression affect Self Care?

Depression affects Self-Care in various ways

Read this summary from Ivonne Leesman-Leegte from the Department of Cardiology at the University Medical Centre of Groningen, the Netherlands.

Cardiovascular Nursing

Self care is the behaviour that a patient undertakes to care for himself to promote health and well being. It can be seen as a decision-making process that patients use in choice of behaviours that maintain physiological stability (symptom monitoring and treatment adherence) and the response to symptoms as they occur. It requires that patients recognize a change; evaluate this change; decide to take action; implement a treatment strategy and evaluate the response to the treatment.

A few years ago this concept of self care behaviour is more specified into different aspects of self care such as Self Care Maintenance, Self Care Management and Self Care Confidence, which was summarized in the Self Care of Heart Failure model. (Riegel 2004).

Self Care Maintenance is defined as the routinely daily practices of patients and patients participating in health seeking behaviour. Self Care Management is defined as the decision making process in symptom monitoring and treatment adherence. Self Care Confidence is the way patients feel worth while to take care for and to invest in seeking help and assistance.

Depression is common in patients with Cardiovascular Diseases and especially in Heart Failure (HF) patients. It is associated with morbidity and mortality, decreased quality of life and increased health care costs. The question is, if there is a link between self care and depression. Does depression complicates self care and where in the above mentioned model can we find the link with depression?

Studies on the relationship between depression and self care are scarce. Only a few small studies in cardiovascular patients, mostly in HF patients, have identified this association. Depression in HF patients might hinder self care through impaired cognition, social isolation, feelings of hopelessness and delay in seeking help. But most research has focused on the relationship between depression and compliance or adherence.

Depression affects Self Care in several ways and it is necessary to improve research in this area. For daily practice it is advised to screen for and treat depression, and improve skills and resources of patients to increase self care.

View corresponding slides from the 10th Annual Spring Meeting on Cardiovacular Nursing