title: Emotional and adjustment issues faced by cardiac patients seen in clinical practice: a qualitative survey of experienced clinicians.
abstract: OBJECTIVE
  Many cardiac patients experience psychological difficulties after a cardiac event including anxiety, depressed mood, adjustment difficulties, and feelings of grief and loss. There is a vast literature on the psychological adjustment of cardiac patients including reports by individual practitioners into the emotional difficulties of these patients. However, no previous study has surveyed therapists collectively about their experiences working with cardiac patients. In this study, clinical practitioners were surveyed to identify specific emotional issues faced by cardiac patients and to explore potential relationships between these issues.
  
  
  METHODS
  Semistructured interviews were conducted with 14 psychologists and cardiac social workers who had extensive experiences with cardiac patients. Responses were collated by means of a qualitative thematic analysis.
  
  
  RESULTS
  Participants described the interrelationships of anxiety, depression, grief and loss, and denial that were observed in cardiac patients. Participants also identified trauma, guilt, and anger as issues of concern.
  
  
  CONCLUSIONS
  The findings supply a richness of detail that is often absent in quantitative studies. This detail may give cardiac rehabilitation professionals additional insight into the complexity of patients' emotional reactions and the interrelationships of these reactions. The results highlight the importance of the identification and referral of patients who present with more than transient emotional difficulties.
authors: Heart Research Centre, Melbourne, Australia. rosemary.higgins@heartresearchcentre.org
authors: Rosemary O
authors: RO
authors: Higgins
authors: Barbara M
authors: BM
authors: Murphy
authors: Angela
authors: A
authors: Nicholas
authors: Marian U C
authors: MU
authors: Worcester
authors: Helen
authors: H
authors: Lindner
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000786:Anger; D001007:Anxiety; D015897:Comorbidity; D003324:Coronary Artery Disease / Q000523:psychology* / Q000534:rehabilitation; D003863:Depression; D004644:Emotions; D005260:Female; D006117:Grief; D006306:Health Surveys; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D011581:Psychological Tests; D036301:Qualitative Research; D012917:Social Adjustment; D011795:Surveys and Questionnaires