Needs and Preferences for Remote-Delivered Mindfulness-Based Cognitive Therapy in Patients After Acute Coronary Syndrome: A Qualitative Study.
Christina M. Luberto, Sydney Crute, Amy Z Wang, Runnan Li, Gloria Y Yeh, Jeff C Huffman, Christopher M Celano, David Victorson, Bettina B. Hoeppner, Elyse R Park
Global advances in integrative medicine and health 2024 DOI: 10.1177/27536130241288213 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Qualitative study Peer reviewed |
|---|---|
| Sample size | 23 |
| Population | Patients after acute coronary syndrome (13 with and 10 without elevated depressive symptoms; mean age 63.4 years, 87% male, 96% non-Hispanic white, average 7.1 years since ACS) |
| Topics | Anxiety Depression Meditation |
| Keywords | Acute coronary syndrome Cardiovascular disease Health behavior Intervention |
| Key findings | ACS patients with elevated depressive symptoms reported emotional, physical, social, and health behavior problems, whereas those without depressive symptoms reported positive health behavior changes alongside anxiety. Both groups wanted behavioral health treatment for emotional and social support, and most were open to a videoconference-delivered mindfulness group. The authors argue that an adapted Mindfulness-Based Cognitive Therapy approach could target these quality-of-life concerns. |
Abstract
Following acute coronary syndrome (ACS), up to 40% of patients report elevated depressive symptoms which is associated with a two-fold increase in mortality risk due to behavioral and biological mechanisms. Mindfulness-Based Cognitive Therapy (MBCT) delivered via synchronous group videoconferencing could help reduce depressive symptoms. To guide MBCT adaptation for ACS patients for a future clinical trial, this qualitative study aimed to explore ACS patients' (1) symptoms after ACS, (2) needs for behavioral health treatment, (3) perspectives on mindfulness intervention and group videoconference delivery, and (4) willingness to self-collect dried blood spots in a research study. We compared ACS patients with and without depressive symptoms to highlight particularly relevant treatment topics for patients developing depression following ACS experience. From 2/2019-11/2019, we conducted semi-structured individual telephone interviews with N = 23 patients after ACS (N = 13 with and N = 10 without elevated depressive symptoms; 63.4 (SD = 8.5) years, 87% male, 96% non-Hispanic white, 7.1 (SD = 7.5) years since ACS). In qualitative content analyses, four independent coders coded each interview. Participants with depressive symptoms experienced emotional, physical, social, and health behavior problems, while those without depressive symptoms made positive health behavior changes and struggled with anxiety symptoms. Both groups were interested in a behavioral health treatment for emotional and social support. Most were willing to participate in a mindfulness group via videoconferencing; some preferred in-person, but accessibility and convenience outweighed these cons. Almost all were willing to self-collect dried blood spots and some were already familiar with this technique. ACS patients, especially those with depressive symptoms, need help managing a multitude of quality of life concerns that can be targeted with an adapted MBCT approach. A videoconference-delivered MBCT approach is of interest. Suggestions for adapting MBCT to target the needs of ACS patients are discussed.