Illness Perceptions and Emotional Experiences in Heart Failure: Qualitative Insights to Inform Personalized...

Heart failure (HF) affects over 6 million US adults, especially older individuals, and is a leading cause of hospitalization with high readmission rates. Psychological distress, particularly depression, is common and linked to negative outcomes.

This study explored illness perceptions and psychosocial experiences in patients with HF, with attention to differences by etiology and sex.

This was a qualitative research study of patients with HF that collected information through semistructured phone interviews and a mailed survey assessing demographic and mental health history. From February 2021 to May 2022, thirty-five patients were recruited and completed the interview. All interviews were audio-recorded, transcribed, and coded using NVivo.

The mean participant age was 71.8 years (standard deviation 11.1), with 22 (63%) males. Eight had a history of depression, and 5 reported anxiety; most linked their symptoms partly to HF. Three major psychosocial themes emerged: (1) Living with Heart Failure, (2) Emotional Experience and Coping, and (3) Personal and CommunitySupport. Emotional responses included depression, anxiety, anger, and frustration. Although many reported strong family support, caregiver stress was noted. Women showed higher rates of depression, anxiety, and antidepressant use, with differences also seen by illness etiology.

This qualitative analysis found that patients with HF adapt to a "new normal" through lifestyle changes, with 4 key themes emerging. Variability within each theme suggests that a one-size-fits-all approach to assessing and managing psychosocial distress may be insufficient, highlighting opportunities for more individualized care in primary and specialty settings.