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Lin CY, Dracup K, Pelter MM, et al. Association of psychological distress with reasons for delay in seeking medical care in rural patients with worsening heart failure symptoms. J Rural Health. 2021;doi: 10.1111/jrh.12573.
Lin, C. Y., Dracup, K., Pelter, M. M., Biddle, M. J., & Moser, D. K. (2021). Association of psychological distress with reasons for delay in seeking medical care in rural patients with worsening heart failure symptoms. The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association, . https://doi.org/10.1111/jrh.12573
Lin, Chin-Yen, et al. "Association of psychological distress with reasons for delay in seeking medical care in rural patients with worsening heart failure symptoms." The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association vol. (2021). doi: https://doi.org/10.1111/jrh.12573
Lin CY, Dracup K, Pelter MM, Biddle MJ, Moser DK. Association of psychological distress with reasons for delay in seeking medical care in rural patients with worsening heart failure symptoms. J Rural Health. 2021 Mar 30; doi: 10.1111/jrh.12573. Epub 2021 Mar 30. PMID: 33783853.
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J Rural Health. 2021 Mar 30; doi: 10.1111/jrh.12573. Epub 2021 Mar 30.

Association of psychological distress with reasons for delay in seeking medical care in rural patients with worsening heart failure symptoms.

The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association

Chin-Yen Lin, Kathleen Dracup, Michele M Pelter, Martha J Biddle, Debra K Moser

Affiliations

  1. College of Nursing, University of Kentucky, Lexington, Kentucky, USA.
  2. School of Nursing, University of California, San Francisco, California, USA.

PMID: 33783853 DOI: 10.1111/jrh.12573

Abstract

BACKGROUND: The impact of depressive symptoms and anxiety on rural patients' decisions to seek care for worsening heart failure (HF) symptoms remains unknown. The purposes of this study were (1) to describe rural patients' reasons for delay in seeking care for HF, and (2) to determine whether depressive symptoms or anxiety was associated with patients' reasons for delay in seeking medical care for worsening symptoms.

METHODS: A total of 611 rural HF patients were included. Data on reasons for patient delay in seeking medical care (The Reasons for Delay Questionnaire), depressive symptoms (PHQ-9), and anxiety (BSI-ANX) were collected. Statistical analyses included chi-square and multiple regression.

RESULTS: A total of 85.4% of patients reported at least 1 reason for delay. Patients with higher levels of depressive symptoms were more likely to cite embarrassment, problems with transportation, and financial concerns as a reason for delay. Patients with anxiety not only cited nonsymptom-related reasons but also reported symptom-related reasons for delay in seeking care (ie, symptoms seemed vague, not sure of symptoms, symptoms didn't seem to be serious enough, and symptoms were different from the last episode). In multiple regression, patients with greater depressive symptoms and anxiety had a greater number of reasons for delay in seeking care (P = .003 and P = .023, respectively).

CONCLUSIONS: Our findings suggest that enhancement of patients' symptom appraisal abilities and improvement in psychological distress may result in a reduction in delay in seeking medical care for worsening symptoms in rural patients with HF.

© 2021 National Rural Health Association.

Keywords: anxiety; depression; reasons for care-seeking delay; rural heart failure patients

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