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Published in: BMC Psychiatry 1/2024

Open Access 01-12-2024 | Pulmonary Hypertension | Research

‘Fear, uncertain, tired…...’ psychological distress among pulmonary hypertension patients: a qualitative interview study

Authors: Juxia Zhang, Yiyin Zhang, Yuhuan Yin, Yuping Feng, Rong Zhang, Hongyan Meng, Jing Wang

Published in: BMC Psychiatry | Issue 1/2024

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Abstract

Background

Patient-centered health care for patients with pulmonary hypertension (PH) is important and requires an understanding of patient experiences. However, there is a lack of approaches to examine what's the effects and how the disease impact patients’ psychological well-beings.

Methods

We conducted qualitative interviews with PH patient representatives to understand patient psychological experiences and inform patient-centered research and care. Participants were chosen from a tertiary hospital located in northwest China. 20 patients with PH who be treated at the hospital (13 participants were women, aged 18-74 years) were strategically selected and individually interviewed. We used qualitative analysis to identify themes relating to existential psychological distress that would clarify the nature of such concerns.

Results

We found that patients experience tremendous psychological distress throughout the treatment process. Four categories that describe patients' psychological experiences emerged: burden of PH treatment, fear and uncertainty about the disease, frustration in social and family role, and lack of recognition of the condition.

Conclusions

Existential concerns are salient in PH and involve the experience of loss and disruptions to the sense of self and relationships. Healthcare practitioners must work more in collaboration to detect patients' need for support and to develop the patient's own skills to manage daily life. The PH teams should tailor interventions to provide emotional, informational and instrumental support and guidance to patients.
Literature
1.
go back to reference Medicine The Lancet Respiratory. Pulmonary hypertension: still a rare disease? Lancet Respir Med. 2016;4(4):241.CrossRef Medicine The Lancet Respiratory. Pulmonary hypertension: still a rare disease? Lancet Respir Med. 2016;4(4):241.CrossRef
2.
go back to reference Humbert M, Kovacs G, Hoeper MM, Badagliacca R, Berger RMF, Brida M, Carlsen J, Coats AJS, Escribano-Subias P, Ferrari P, Ferreira DS, Ghofrani HA, Giannakoulas G, Kiely DG, Mayer E, Meszaros G, Nagavci B, Olsson KM, Pepke-Zaba J, Quint JK, Rådegran G, Simonneau G, Sitbon O, Tonia T, Toshner M, Vachiery JL, Vonk Noordegraaf A, Delcroix M, Rosenkranz S; ESC/ERS Scientific Document Group. 2022 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension. Eur Respir J. 2023;61(1):2200879. Humbert M, Kovacs G, Hoeper MM, Badagliacca R, Berger RMF, Brida M, Carlsen J, Coats AJS, Escribano-Subias P, Ferrari P, Ferreira DS, Ghofrani HA, Giannakoulas G, Kiely DG, Mayer E, Meszaros G, Nagavci B, Olsson KM, Pepke-Zaba J, Quint JK, Rådegran G, Simonneau G, Sitbon O, Tonia T, Toshner M, Vachiery JL, Vonk Noordegraaf A, Delcroix M, Rosenkranz S; ESC/ERS Scientific Document Group. 2022 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension. Eur Respir J. 2023;61(1):2200879.
3.
go back to reference Rosenkranz S, Delcroix M, Giannakoulas G, Hoeper MM, Kovacs G, Humbert M. The “Ten Commandments” of the 2022 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension. Eur Heart J. 2023;44(10):792–3.PubMedCrossRef Rosenkranz S, Delcroix M, Giannakoulas G, Hoeper MM, Kovacs G, Humbert M. The “Ten Commandments” of the 2022 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension. Eur Heart J. 2023;44(10):792–3.PubMedCrossRef
4.
go back to reference Gelzinis TA. Pulmonary Hypertension in 2021: Part I-Definition, Classification, Pathophysiology, and Presentation. J Cardiothorac Vasc Anesth. 2022;36(6):1552–64.PubMedCrossRef Gelzinis TA. Pulmonary Hypertension in 2021: Part I-Definition, Classification, Pathophysiology, and Presentation. J Cardiothorac Vasc Anesth. 2022;36(6):1552–64.PubMedCrossRef
5.
go back to reference Van Nuffel S, Quatredeniers M, Pirkl A, Zakel J, Le Caer JP, Elie N, Vanbellingen QP, Dumas SJ, Nakhleh MK, Ghigna MR, Fadel E, Humbert M, Chaurand P, Touboul D, Cohen-Kaminsky S, Brunelle A. Multimodal Imaging Mass Spectrometry to Identify Markers of Pulmonary Arterial Hypertension in Human Lung Tissue Using MALDI-ToF, ToF-SIMS, and Hybrid SIMS. Anal Chem. 2020;92(17):12079–87.PubMedCrossRef Van Nuffel S, Quatredeniers M, Pirkl A, Zakel J, Le Caer JP, Elie N, Vanbellingen QP, Dumas SJ, Nakhleh MK, Ghigna MR, Fadel E, Humbert M, Chaurand P, Touboul D, Cohen-Kaminsky S, Brunelle A. Multimodal Imaging Mass Spectrometry to Identify Markers of Pulmonary Arterial Hypertension in Human Lung Tissue Using MALDI-ToF, ToF-SIMS, and Hybrid SIMS. Anal Chem. 2020;92(17):12079–87.PubMedCrossRef
7.
go back to reference Zhang R, Dai LZ, Xie WP, Yu ZX, Wu BX, Pan L, Yuan P, Jiang X, He J, Humbert M, Jing ZC. Survival of Chinese patients with pulmonary arterial hypertension in the modern treatment era. Chest. 2011;140(2):301–9.PubMedCrossRef Zhang R, Dai LZ, Xie WP, Yu ZX, Wu BX, Pan L, Yuan P, Jiang X, He J, Humbert M, Jing ZC. Survival of Chinese patients with pulmonary arterial hypertension in the modern treatment era. Chest. 2011;140(2):301–9.PubMedCrossRef
8.
go back to reference Zoppellaro G, Badawy MR, Squizzato A, Denas G, Tarantini G, Pengo V. Balloon Pulmonary Angioplasty in Patients With Chronic Thromboembolic Pulmonary Hypertension - A Systematic Review and Meta-Analysis. Circ J. 2019;83(8):1660–7.PubMedCrossRef Zoppellaro G, Badawy MR, Squizzato A, Denas G, Tarantini G, Pengo V. Balloon Pulmonary Angioplasty in Patients With Chronic Thromboembolic Pulmonary Hypertension - A Systematic Review and Meta-Analysis. Circ J. 2019;83(8):1660–7.PubMedCrossRef
9.
go back to reference Guillevin L, Armstrong I, Aldrighetti R, Howard LS, Ryftenius H, Fischer A, Lombardi S, Studer S, Ferrari P. Understanding the impact of pulmonary arterial hypertension on patients’ and carers’ lives. Eur Respir Rev. 2013;22(130):535–42.PubMedPubMedCentralCrossRef Guillevin L, Armstrong I, Aldrighetti R, Howard LS, Ryftenius H, Fischer A, Lombardi S, Studer S, Ferrari P. Understanding the impact of pulmonary arterial hypertension on patients’ and carers’ lives. Eur Respir Rev. 2013;22(130):535–42.PubMedPubMedCentralCrossRef
10.
go back to reference Mai AS, Lim OZH, Ho YJ, Kong G, Lim GEH, Ng CH, Ho C, Ho R, Lim Y, Kuntjoro I, Tay E, Yip J, Chew NWS, Low TT. Prevalence, risk factors and intervention for depression and anxiety in pulmonary hypertension: a systematic review and meta-analysis. Front Med (Lausanne). 2022;9:765461.PubMedCrossRef Mai AS, Lim OZH, Ho YJ, Kong G, Lim GEH, Ng CH, Ho C, Ho R, Lim Y, Kuntjoro I, Tay E, Yip J, Chew NWS, Low TT. Prevalence, risk factors and intervention for depression and anxiety in pulmonary hypertension: a systematic review and meta-analysis. Front Med (Lausanne). 2022;9:765461.PubMedCrossRef
11.
go back to reference Zhou X, Shi H, Yang Y, Zhang Z, Zhai Z, Wang C. Anxiety and depression in patients with pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension: results from a Chinese survey. Exp Ther Med. 2020;19(4):3124–32.PubMedPubMedCentral Zhou X, Shi H, Yang Y, Zhang Z, Zhai Z, Wang C. Anxiety and depression in patients with pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension: results from a Chinese survey. Exp Ther Med. 2020;19(4):3124–32.PubMedPubMedCentral
12.
go back to reference Somaini G, Hasler ED, Saxer S, Huber LC, Lichtblau M, Speich R, Bloch KE, Ulrich S. Prevalence of anxiety and depression in pulmonary hypertension and changes during therapy. Respiration. 2016;91(5):359–66.PubMedCrossRef Somaini G, Hasler ED, Saxer S, Huber LC, Lichtblau M, Speich R, Bloch KE, Ulrich S. Prevalence of anxiety and depression in pulmonary hypertension and changes during therapy. Respiration. 2016;91(5):359–66.PubMedCrossRef
13.
go back to reference Nakazato L, Mendes F, Paschoal IA, Oliveira DC, Moreira MM, Pereira MC. Association of daily physical activity with psychosocial aspects and functional capacity in patients with pulmonary arterial hypertension: a cross-sectional study. Pulm Circ. 2021;11(2):2045894021999955.PubMedPubMedCentralCrossRef Nakazato L, Mendes F, Paschoal IA, Oliveira DC, Moreira MM, Pereira MC. Association of daily physical activity with psychosocial aspects and functional capacity in patients with pulmonary arterial hypertension: a cross-sectional study. Pulm Circ. 2021;11(2):2045894021999955.PubMedPubMedCentralCrossRef
14.
15.
go back to reference Olsson KM, Meltendorf T, Fuge J, Kamp JC, Park DH, Richter MJ, Gall H, Ghofrani HA, Ferrari P, Schmiedel R, Kulla HD, Heitland I, Lepsy N, Dering MR, Hoeper MM, Kahl KG. Prevalence of Mental Disorders and Impact on Quality of Life in Patients With Pulmonary Arterial Hypertension. Front Psychiatry. 2021;12:667602.PubMedPubMedCentralCrossRef Olsson KM, Meltendorf T, Fuge J, Kamp JC, Park DH, Richter MJ, Gall H, Ghofrani HA, Ferrari P, Schmiedel R, Kulla HD, Heitland I, Lepsy N, Dering MR, Hoeper MM, Kahl KG. Prevalence of Mental Disorders and Impact on Quality of Life in Patients With Pulmonary Arterial Hypertension. Front Psychiatry. 2021;12:667602.PubMedPubMedCentralCrossRef
16.
go back to reference Pfeuffer E, Krannich H, Halank M, Wilkens H, Kolb P, Jany B, Held M. Anxiety, depression, and health-related QOL in patients diagnosed with PAH or CTEPH. Lung. 2017;195(6):759–68.PubMedCrossRef Pfeuffer E, Krannich H, Halank M, Wilkens H, Kolb P, Jany B, Held M. Anxiety, depression, and health-related QOL in patients diagnosed with PAH or CTEPH. Lung. 2017;195(6):759–68.PubMedCrossRef
17.
18.
go back to reference Rawlings GH, Beail N, Armstrong I, Condliffe R, Kiely DG, Sabroe I, Thompson AR. Adults’ experiences of living with pulmonary hypertension: a thematic synthesis of qualitative studies. BMJ Open. 2020;10(12):e041428.PubMedPubMedCentralCrossRef Rawlings GH, Beail N, Armstrong I, Condliffe R, Kiely DG, Sabroe I, Thompson AR. Adults’ experiences of living with pulmonary hypertension: a thematic synthesis of qualitative studies. BMJ Open. 2020;10(12):e041428.PubMedPubMedCentralCrossRef
19.
go back to reference Ma W, Ma H, Wang Y, Wang J, Wang H, Wang S. 2021 Medical quality report of cardiovascular diseases in China: an executive summary. J Chin Circ. 2021;36(11):1041–64. Ma W, Ma H, Wang Y, Wang J, Wang H, Wang S. 2021 Medical quality report of cardiovascular diseases in China: an executive summary. J Chin Circ. 2021;36(11):1041–64.
20.
go back to reference Chiang YC, Hu LY, Couper J, Cheng CC, Wang LH, Huang WC, Lu T. Exploring the experiences and psychosocial stresses of Taiwanese patients with pulmonary hypertension: a qualitative interview study. Pulm Circ. 2018;8(3):2045894018787479.PubMedPubMedCentralCrossRef Chiang YC, Hu LY, Couper J, Cheng CC, Wang LH, Huang WC, Lu T. Exploring the experiences and psychosocial stresses of Taiwanese patients with pulmonary hypertension: a qualitative interview study. Pulm Circ. 2018;8(3):2045894018787479.PubMedPubMedCentralCrossRef
21.
go back to reference Zhang J, Yin Y, Wen Y, Shi F, Wang J. Anxiety and depression in patients with pulmonary arterial hypertension in northwest china: a cross-sectional study. Front Psychiatry. 2022;12: 758120.PubMedPubMedCentralCrossRef Zhang J, Yin Y, Wen Y, Shi F, Wang J. Anxiety and depression in patients with pulmonary arterial hypertension in northwest china: a cross-sectional study. Front Psychiatry. 2022;12: 758120.PubMedPubMedCentralCrossRef
22.
go back to reference Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007;19(6):349–57.PubMedCrossRef Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007;19(6):349–57.PubMedCrossRef
23.
go back to reference Edward KL, Welch T. The extension of Colaizzi’s method of phenomenological enquiry. Contemp Nurse. 2011;39(2):163–71.PubMed Edward KL, Welch T. The extension of Colaizzi’s method of phenomenological enquiry. Contemp Nurse. 2011;39(2):163–71.PubMed
24.
go back to reference Kingman M, Hinzmann B, Sweet O, Vachiéry JL. Living with pulmonary hypertension: unique insights from an international ethnographic study. BMJ Open. 2014;4(5):e004735.PubMedPubMedCentralCrossRef Kingman M, Hinzmann B, Sweet O, Vachiéry JL. Living with pulmonary hypertension: unique insights from an international ethnographic study. BMJ Open. 2014;4(5):e004735.PubMedPubMedCentralCrossRef
25.
go back to reference McDonough A, Matura LA, Carroll DL. Symptom experience of pulmonary arterial hypertension patients. Clin Nurs Res. 2011;20(2):120–34.PubMedCrossRef McDonough A, Matura LA, Carroll DL. Symptom experience of pulmonary arterial hypertension patients. Clin Nurs Res. 2011;20(2):120–34.PubMedCrossRef
26.
go back to reference Strange G, Gabbay E, Kermeen F, Williams T, Carrington M, Stewart S, Keogh A. Time from symptoms to definitive diagnosis of idiopathic pulmonary arterial hypertension: the delay study. Pulm Circ. 2013;3(1):89–94.PubMedPubMedCentralCrossRef Strange G, Gabbay E, Kermeen F, Williams T, Carrington M, Stewart S, Keogh A. Time from symptoms to definitive diagnosis of idiopathic pulmonary arterial hypertension: the delay study. Pulm Circ. 2013;3(1):89–94.PubMedPubMedCentralCrossRef
27.
go back to reference Ivarsson B, Johansson A, Kjellström B. The odyssey from symptom to diagnosis of pulmonary hypertension from the patients and spouses perspective. J Prim Care Community Health. 2021;12:21501327211029240.PubMedPubMedCentralCrossRef Ivarsson B, Johansson A, Kjellström B. The odyssey from symptom to diagnosis of pulmonary hypertension from the patients and spouses perspective. J Prim Care Community Health. 2021;12:21501327211029240.PubMedPubMedCentralCrossRef
28.
go back to reference Matura LA, McDonough A, Aglietti LM, Herzog JL, Gallant KA. A virtual community: concerns of patients with pulmonary hypertension. Clin Nurs Res. 2013;22(2):155–71.PubMedCrossRef Matura LA, McDonough A, Aglietti LM, Herzog JL, Gallant KA. A virtual community: concerns of patients with pulmonary hypertension. Clin Nurs Res. 2013;22(2):155–71.PubMedCrossRef
29.
go back to reference Carroll R, Antigua J, Taichman D, Palevsky H, Forfia P, Kawut S, Halpern SD. Motivations of patients with pulmonary arterial hypertension to participate in randomized clinical trials. Clin Trials. 2012;9(3):348–57.PubMedPubMedCentralCrossRef Carroll R, Antigua J, Taichman D, Palevsky H, Forfia P, Kawut S, Halpern SD. Motivations of patients with pulmonary arterial hypertension to participate in randomized clinical trials. Clin Trials. 2012;9(3):348–57.PubMedPubMedCentralCrossRef
30.
go back to reference Matura LA, McDonough A, Hanlon AL, Carroll DL, Riegel B. Sleep disturbance, symptoms, psychological distress, and health-related quality of life in pulmonary arterial hypertension. Eur J Cardiovasc Nurs. 2015;14(5):423–30.PubMedCrossRef Matura LA, McDonough A, Hanlon AL, Carroll DL, Riegel B. Sleep disturbance, symptoms, psychological distress, and health-related quality of life in pulmonary arterial hypertension. Eur J Cardiovasc Nurs. 2015;14(5):423–30.PubMedCrossRef
31.
go back to reference Wolk R, Gami AS, Garcia-Touchard A, Somers VK. leep and cardiovascular disease. Curr Problems Cardiol. 2005;30(12):625–62.CrossRef Wolk R, Gami AS, Garcia-Touchard A, Somers VK. leep and cardiovascular disease. Curr Problems Cardiol. 2005;30(12):625–62.CrossRef
32.
go back to reference Kwok CS, Kontopantelis E, Kuligowski G, Gray M, Muhyaldeen A, Gale CP, Peat GM, Cleator J, Chew-Graham C, Loke YK, Mamas MA. Self-reported sleep duration and quality and cardiovascular disease and mortality: a dose-response meta-analysis. J Am Heart Assoc. 2018;7(15):e008552.PubMedPubMedCentralCrossRef Kwok CS, Kontopantelis E, Kuligowski G, Gray M, Muhyaldeen A, Gale CP, Peat GM, Cleator J, Chew-Graham C, Loke YK, Mamas MA. Self-reported sleep duration and quality and cardiovascular disease and mortality: a dose-response meta-analysis. J Am Heart Assoc. 2018;7(15):e008552.PubMedPubMedCentralCrossRef
33.
34.
go back to reference Lo C, Sarker T, Canning O, Martin V, McCarthy MA, Granton J, Adrienne T. Clinical presentation of existential distress in pulmonary arterial hypertension. Can J Respir Crit Care Sleep Med. 2019;3(1):56–62. Lo C, Sarker T, Canning O, Martin V, McCarthy MA, Granton J, Adrienne T. Clinical presentation of existential distress in pulmonary arterial hypertension. Can J Respir Crit Care Sleep Med. 2019;3(1):56–62.
35.
go back to reference Tsangaris I. Improving patient care in pulmonary arterial hypertension: addressing psychosocial issues. J Clin Hypertens (Greenwich). 2014;16(3):159–61.PubMedCrossRef Tsangaris I. Improving patient care in pulmonary arterial hypertension: addressing psychosocial issues. J Clin Hypertens (Greenwich). 2014;16(3):159–61.PubMedCrossRef
36.
go back to reference Swetz KM, Shanafelt TD, Drozdowicz LB, Sloan JA, Novotny PJ, Durst LA, Frantz RP, McGoon MD. Symptom burden, quality of life, and attitudes toward palliative care in patients with pulmonary arterial hypertension: results from a cross-sectional patient survey. J Heart Lung Transplant. 2012;31(10):1102–8.PubMedCrossRef Swetz KM, Shanafelt TD, Drozdowicz LB, Sloan JA, Novotny PJ, Durst LA, Frantz RP, McGoon MD. Symptom burden, quality of life, and attitudes toward palliative care in patients with pulmonary arterial hypertension: results from a cross-sectional patient survey. J Heart Lung Transplant. 2012;31(10):1102–8.PubMedCrossRef
37.
go back to reference Harzheim D, Klose H, Pinado FP, Ehlken N, Nagel C, Fischer C, Ghofrani A, Rosenkranz S, Seyfarth HJ, Halank M, Mayer E, Grünig E, Guth S. Anxiety and depression disorders in patients with pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension. Respir Res. 2013;14(1):104.PubMedPubMedCentralCrossRef Harzheim D, Klose H, Pinado FP, Ehlken N, Nagel C, Fischer C, Ghofrani A, Rosenkranz S, Seyfarth HJ, Halank M, Mayer E, Grünig E, Guth S. Anxiety and depression disorders in patients with pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension. Respir Res. 2013;14(1):104.PubMedPubMedCentralCrossRef
38.
go back to reference Löwe B, Gräfe K, Ufer C, Kroenke K, Grünig E, Herzog W, et al. (2004). Anxiety and depression in patients with pulmonary hypertension. Psychosomatic Med. 2004; 66(6): 831–836. Löwe B, Gräfe K, Ufer C, Kroenke K, Grünig E, Herzog W, et al. (2004). Anxiety and depression in patients with pulmonary hypertension. Psychosomatic Med. 2004; 66(6): 831–836.
39.
go back to reference Pepke-Zaba J, Delcroix M, Lang I, Mayer E, Jansa P, Ambroz D, Treacy C, D’Armini AM, Morsolini M, Snijder R, Bresser P, Torbicki A, Kristensen B, Lewczuk J, Simkova I, Barberà JA, de Perrot M, Hoeper MM, Gaine S, Speich R, Gomez-Sanchez MA, Kovacs G, Hamid AM, Jaïs X, Simonneau G. Chronic thromboembolic pulmonary hypertension (CTEPH): results from an international prospective registry. Circulation. 2011;124(18):1973–81.PubMedCrossRef Pepke-Zaba J, Delcroix M, Lang I, Mayer E, Jansa P, Ambroz D, Treacy C, D’Armini AM, Morsolini M, Snijder R, Bresser P, Torbicki A, Kristensen B, Lewczuk J, Simkova I, Barberà JA, de Perrot M, Hoeper MM, Gaine S, Speich R, Gomez-Sanchez MA, Kovacs G, Hamid AM, Jaïs X, Simonneau G. Chronic thromboembolic pulmonary hypertension (CTEPH): results from an international prospective registry. Circulation. 2011;124(18):1973–81.PubMedCrossRef
40.
go back to reference Boon GJAM, van den Hout WB, Barco S, Bogaard HJ, Delcroix M, Huisman MV, Konstantinides SV, Meijboom LJ, Nossent EJ, Symersky P, Vonk Noordegraaf A, Klok FA. A model for estimating the health economic impact of earlier diagnosis of chronic thromboembolic pulmonary hypertension. ERJ Open Res. 2021;7(3):00719–2020.PubMedPubMedCentralCrossRef Boon GJAM, van den Hout WB, Barco S, Bogaard HJ, Delcroix M, Huisman MV, Konstantinides SV, Meijboom LJ, Nossent EJ, Symersky P, Vonk Noordegraaf A, Klok FA. A model for estimating the health economic impact of earlier diagnosis of chronic thromboembolic pulmonary hypertension. ERJ Open Res. 2021;7(3):00719–2020.PubMedPubMedCentralCrossRef
41.
go back to reference Hug KP, Gerry Coghlan J, Cannon J, Taboada D, Toshner M, Sheares K, Ruggiero A, Screaton N, Jenkins D, Pepke-Zaba J, Hoole SP. Serial right heart catheter assessment between balloon pulmonary angioplasty sessions identify procedural factors that influence response to treatment. J Heart Lung Transplant. 2021;40(10):1223–34.PubMedCrossRef Hug KP, Gerry Coghlan J, Cannon J, Taboada D, Toshner M, Sheares K, Ruggiero A, Screaton N, Jenkins D, Pepke-Zaba J, Hoole SP. Serial right heart catheter assessment between balloon pulmonary angioplasty sessions identify procedural factors that influence response to treatment. J Heart Lung Transplant. 2021;40(10):1223–34.PubMedCrossRef
42.
go back to reference Kjellström B, Sandqvist A, Hjalmarsson C, Nisell M, Näsman P, Ivarsson B. Adherence to disease-specific drug treatment among patients with pulmonary arterial hypertension or chronic thromboembolic pulmonary hypertension. ERJ Open Res. 2020;6(4):00299–2020.PubMedPubMedCentralCrossRef Kjellström B, Sandqvist A, Hjalmarsson C, Nisell M, Näsman P, Ivarsson B. Adherence to disease-specific drug treatment among patients with pulmonary arterial hypertension or chronic thromboembolic pulmonary hypertension. ERJ Open Res. 2020;6(4):00299–2020.PubMedPubMedCentralCrossRef
43.
go back to reference Frantz RP, Hill JW, Lickert CA, Wade RL, Cole MR, Tsang Y, Drake W 3rd. Medication adherence, hospitalization, and healthcare resource utilization and costs in patients with pulmonary arterial hypertension treated with endothelin receptor antagonists or phosphodiesterase type-5 inhibitors. Pulm Circ. 2020 18;10(1):2045894019880086. Frantz RP, Hill JW, Lickert CA, Wade RL, Cole MR, Tsang Y, Drake W 3rd. Medication adherence, hospitalization, and healthcare resource utilization and costs in patients with pulmonary arterial hypertension treated with endothelin receptor antagonists or phosphodiesterase type-5 inhibitors. Pulm Circ. 2020 18;10(1):2045894019880086.
44.
go back to reference Ivarsson B, Rådegran G, Hesselstrand R, Kjellström B. Information, social support and coping in patients with pulmonary arterial hypertension or chronic thromboembolic pulmonary hypertension-A nationwide population-based study. Patient Educ Couns. 2017;100(5):936–42.PubMedCrossRef Ivarsson B, Rådegran G, Hesselstrand R, Kjellström B. Information, social support and coping in patients with pulmonary arterial hypertension or chronic thromboembolic pulmonary hypertension-A nationwide population-based study. Patient Educ Couns. 2017;100(5):936–42.PubMedCrossRef
Metadata
Title
‘Fear, uncertain, tired…...’ psychological distress among pulmonary hypertension patients: a qualitative interview study
Authors
Juxia Zhang
Yiyin Zhang
Yuhuan Yin
Yuping Feng
Rong Zhang
Hongyan Meng
Jing Wang
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2024
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-024-05539-z

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