Patients want to know about the \u27cardiac blues\u27

BACKGROUND: Much attention has been given to identifying and supporting the minority of patients who develop severe clinical depression after a cardiac event. However, relatively little has been given to supporting the many patients who experience transient but significant emotional disturbance that we term the \u27cardiac blues\u27. OBJECTIVE: The aim of this study was to investigate patients\u27 preferences regarding information provision about cardiac blues. METHODS: One hundred and sixty consecutive cardiac patients admitted to two Victorian hospitals in Australia were interviewed three times over six months. They were asked about emotional issues, including information provision preferences. RESULTS: Four out of five (81%) patients would like to have received information about the cardiac blues, but only a minority received this information. CONCLUSION: Most patients want to know about cardiac blues. The development and evaluation of resources for health professionals and patients to support recovery through cardiac blues appears warranted

Bundap Marram Durn Durn : engagement with Aboriginal women experiencing comorbid chronic physical and mental health conditions

Objective: To explore antecedents of health service engagement and experience among urban Aboriginal people with comorbid physical and mental health conditions. Methods: Focus groups and interviews were conducted with Aboriginal people who had comorbid health conditions and were accessing Aboriginal and/or mainstream services. Results: Nineteen participants, all women, were recruited. Participants’ personal histories and prior experience of health services affected effective service utilisation. Participants’ service experiences were characterised by long waiting times in the public health system and high healthcare staff turnover. Trusted professionals were able to act as brokers to other clinically and culturally competent practitioners. Conclusions: Many urban Aboriginal women attended health services with multiple comorbid conditions including chronic disease and mental health issues. Several barriers and enablers were identified concerning the capacity of services to engage and effectively manage Aboriginal patients’ conditions. Implications: Results indicate the need to explore strategies to improve health care utilisation by urban Aboriginal women

Bundap Marram Durn Durn: Engagement with Aboriginal women experiencing comorbid chronic physical and mental health conditions

Abstract Objective: To explore antecedents of health service engagement and experience among urban Aboriginal people with comorbid physical and mental health conditions. Methods: Focus groups and interviews were conducted with Aboriginal people who had comorbid health conditions and were accessing Aboriginal and/or mainstream services. Results: Nineteen participants, all women, were recruited. Participants' personal histories and prior experience of health services affected effective service utilisation. Participants’ service experiences were characterised by long waiting times in the public health system and high healthcare staff turnover. Trusted professionals were able to act as brokers to other clinically and culturally competent practitioners. Conclusions: Many urban Aboriginal women attended health services with multiple comorbid conditions including chronic disease and mental health issues. Several barriers and enablers were identified concerning the capacity of services to engage and effectively manage Aboriginal patients’ conditions. Implications: Results indicate the need to explore strategies to improve health care utilisation by urban Aboriginal women

Mild depression predicts long-term mortality after acute myocardial infarction : A 25-year follow-up

Background Past studies have found that depression is an independent predictor of death in patients after acute myocardial infarction (AMI). Our aim was to investigate whether the adverse effect upon mortality of depression, including mild levels, persisted up to 25 years. Methods We used an historical design to study patients who had been consecutively admitted to hospital after transmural AMI during the 1980s and enrolled in an exercise training trial. The Beck Depression Inventory (BDI) was administered to 188 patients in the third week after hospital admission. Scores were trichotomised and classified as low (0–5), mild (6–9) or moderate to severe (≥10) depression. The Australian National Death Index was used to determine mortality status. Cox proportional-hazards modelling was undertaken to determine the relationship between the trichotomised BDI-I scores and all-cause mortality over five time periods up to 25 years. Results The mean age of patients was 54.15 years. One hundred fourteen (114) (60.4%) had low or no depression, 47 (25.2%) mild depression and 27 (14.3%) moderate to severe depression. The mortality status of 185 (98.4%) patients was established. Depression was a significant predictor of death, independently of age and severity of myocardial infarction, at 5, 10 and 15 years but not at 20 or 25 years. Patients with mild depression had greater mortality than those with low or moderate to severe depression. Conclusions Early identification of depression, including milder levels, is important since patients remain at increased risk for many years. They require ongoing monitoring and appropriate treatment