Title:Towards Optimal Heart Failure Care: Couples-Oriented Strategies to Improve Patient Adherence and Health Outcomes
VOLUME: 12 ISSUE: 3
Author(s):Samia R. Toukhsati and David L. Hare
Affiliation:Department of Cardiology, Austin Health, P.O. Box: 5555, Heidelberg, Australia.
Keywords:Chronic Heart Failure, Adherence, Self care, Depression, Secondary prevention, Social support, Couples therapy.
Abstract:Psychosocial factors play an important role in the development and
progression of cardiovascular diseases (CVD), such as chronic heart failure
(CHF). In particular, psycho-cognitive disturbance is common in CHF, which
presents additional challenges to secondary prevention and management strategies.
This review provides a summary of the contemporary psycho-cardiology literature,
including coverage of common mood and cognitive symptoms, and explores
some of the pathophysiologic evidence linking psycho-cognition to CHF, with
particular emphasis on sympathetic nervous system activation and neuroendocrine
functioning. Social support is identified as a strategy by which to reduce depressive
symptoms, manage cognitive impairment and to, potentially, improve health
outcomes through improved patient self care and adherence. Recent research outcomes suggest that
the integration of family caregivers into CHF psycho-educational disease management programs, as
providers and recipients of support, may achieve best outcomes. In this regard, couples-oriented
strategies that promote communication, emotional attachment and support may enhance healthpromoting
behaviours in patients and their partners.
