Depression and Heart Failure Assessment, Treatment, and Interventions to Improve Self-Care Behaviors.

Many people with heart failure also have untreated depression. Because depression can lead to worse self-care and increased morbidity and mortality for patients with heart failure, identification and treatment are essential. Nurses in clinic and inpatient settings are uniquely positioned to implement depression screening and advocate for evidence-based treatment for heart failure patients with depression. Treatments may include pharmacologic therapies, cognitive behavioral therapy, exercise, including cardiac rehabilitation, and social support. Adequate screening, treatment, and education by nurses have the potential to improve self-care for heart failure patients, thus improving morbidity and mortality of this vulnerable population.

Heart Failure Care Delivery in the COVID-19 Era: The Patients' Perspective.

Purpose: The SARS-CoV-2 pandemic is changing healthcare delivery around the world with hospital systems experiencing a dramatic decline in patient volumes. Surveying our center's heart failure (HF) clinic population, we aimed to understand our patients' perception of coronavirus disease 2019 (COVID-19) and care delivery preferences. Methods: Patients with chronic HF presenting either in-person or virtually were approached to complete a ten question, anonymous, voluntary survey. Acutely decompensated patients and heart transplant recipients were excluded. Results: 109 patients completed the survey. Average age was 62 ± 14 years, 67% were male, and 59% had HF with reduced ejection fraction (HFrEF). Overall, patients were worried about contracting COVID-19 and believed they were prone to more severe infection given their underlying HF. However, they were not hesitant to initiate healthcare contact for symptoms and preferred in-person appointments over virtual visits. Although the difference did not reach statistical significance, female patients and those with HF with preserved ejection fraction (HFpEF) were more concerned. Conclusions: Patients with HF are concerned about their increased risk of contracting COVID-19. However, they are actively seeking healthcare contact and prefer in-person over virtual visits.