The effect of cognitive‐behavioral therapy on death anxiety and depression in patients with heart failure: A quasi‐experimental study

Abstract

Purpose: In this study, the effect of cognitive-behavioral therapy (CBT) on death anxiety and depression was investigated in patients with heart failure. Design and Methods:In this quasi-experimental study, 66 patients with heart failure were randomly assigned to intervention (n = 33) and control (n = 33) groups. Data collection was done using a demographic questionnaire, Templer death anxiety scale, and Beck depression inventory. Findings: It was found that the overall scores of death anxiety and depression in posttest were significantly lower than those at the follow-up stage in the intervention group. Practice Implications: CBT could significantly reduce death anxiety and depression in patients with heart failure. Therefore, it is recommended to equip nurses with CBT trainings to manage patients with heart failure better. K E Y W O R D S cognitive-behavioral therapy, death anxiety, depression, heart failure 1 | INTRODUCTION Cardiovascular diseases (CVDs), especially heart failure, are the leading cause of death worldwide. Merely in 2019, more than 18.5 million people died from CVDs globally (Roth et al., 2020). Heart failure is a complex and progressive clinical syndrome caused by a functional or structural cardiac abnormality, leading to failure or inability of ventricles to fill or eject blood. Common signs and symptoms of this disease include shortness of breath with activity or when lying down, fatigue and weakness, swelling in the legs, rapid or irregular heartbeat, persistent cough or wheezing, increased need to urinate at night, abdominal swelling (ascites), very rapid weight gain due to fluid retention, loss of appetite, and nausea (McDonagh et al., 2021). It is

Effects of different psychosocial interventions on death anxiety in patients: a network meta-analysis of randomized controlled trials

“…Our analysis encompassed 15 RCTs in total, involving a cohort of 926 patients. The interventions in experimental group comprised the following: spiritual care (1 study) ( Amini et al, 2020 ), group logotherapy (2 studies) ( Emafti et al, 2019 ; Heidary et al, 2023 ), acceptance and commitment therapy (3 studies) ( Farahi and Khalatbari, 2019 ; Sahebanmaleki et al, 2021 ; Fadhil et al, 2022 ), cognitive-behavioral therapy (2 studies) ( Moradi et al, 2022 ; Saki et al, 2022 ), logotherapy (2 studies) ( Akbari et al, 2021 ; Bahar et al, 2021 ), rational-emotive hospice care therapy (1 study) ( Onyechi et al, 2016 ), spirituality therapy training (1 study) ( Ameri et al, 2021 ), positive psychology group therapy (1 study) ( Saeedi et al, 2016 ), mindfulness based cognitive therapy (1 study) ( Nabipour et al, 2018 ), and white noise and Benson’s relaxation technique (1 study) ( Ahmadi et al, 2022 ). Thirteen studies utilized TDAS as an outcome indicator.…”

“…This research seeks to explore and compare these interventions, providing evidence-based insights into their effectiveness in reducing death anxiety among patients. Several therapeutic approaches, such as spiritual care, group logotherapy, acceptance and commitment therapy, cognitive-behavioral therapy, and rational-emotive hospice care therapy have been empirically proven to effectively alleviate the experience of DA in patients ( Onyechi et al, 2016 ; Saeedi et al, 2016 ; Nabipour et al, 2018 ; Emafti et al, 2019 ; Farahi and Khalatbari, 2019 ; Amini et al, 2020 ; Akbari et al, 2021 ; Ameri et al, 2021 ; Bahar et al, 2021 ; Sahebanmaleki et al, 2021 ; Ahmadi et al, 2022 ; Fadhil et al, 2022 ; Moradi et al, 2022 ; Saki et al, 2022 ; Heidary et al, 2023 ). This meta-analysis exclusively includes randomized controlled trials (RCTs) to ensure the highest level of evidence and minimize bias.…”

“…Cognitive-behavioral therapy is a psychological therapy that can alleviate the psychological burden of individual diseases and help patients recover normal functions ( Enright, 1997 ). An research by Mohsen revealed that cognitive-behavioral therapy remarkably diminishes DA and depression in patients with heart failure ( Moradi et al, 2022 ).…”

Clinical effects of cognitive behavioral therapy in heart failure patients: a meta-analysis of randomized controlled trials

“…Regarding the site of included trials, four trials were conducted in the USA [ 20 – 23 ]. Two studies were conducted in Iran [ 24 , 25 ], and one study was conducted in the Philippines [ 19 ] The least follow-up period was one month [ 25 ], and the most extended follow-up period was 32 weeks [ 22 ]. Further details regarding CBT details and studies’ conclusion are shown in Table 1 .…”

Low body mass index and disease duration as factors associated with depressive symptoms of Chinese inpatients with chronic heart failure

“…Neither the 2021 ESC HF guidelines (Wilkowska et al, 2022) nor the 2022 AHA/ACC/HFSA guidelines (Heidenreich et al, 2022) give a specific recommendation to address depression in patients with HF, because conventional therapies such as antidepressants have not been effective at improving outcomes. Studies show that Cognitive Behavioral Therapy (CBT) (Moradi et al, 2022a), physical exercise (Blumenthal et al, 2012), blended collaborative care (Rollman et al, 2021), and early palliative care (Romanò et al, 2020) reduce depression in patients with HF.…”