Psychological self-care in chronic illness: a cross-sectional mixed-methods examination of strategies used by adults with cardiovascular disease

AIMS: Most of what we know about self-care of cardiovascular disease is focused on physical aspects of illness. The purpose of this study was to explore the extent to which adults with chronic cardiovascular disease engage in psychological self-care. METHODS AND RESULTS: We conducted a concurrent mixed-methods study on psychological self-care among adults with cardiovascular disease. Self-care was measured using the Self-Care of Chronic Illness inventory, and depression was captured using the PROMIS measure. Participants were asked open-ended questions about what they do to maintain and monitor psychological health and wellness, as well as how they manage stress, anxiety, or depression when they occur. Participants also were asked to indicate which strategies they use for managing stress or anxiety and feeling down or depressed from picklists of common strategies. Qualitative data were analysed using content analysis, and results were compared based on a 2×2 matrix of the degree of depressive symptoms and adequacy of self-care. The sample (n = 384) was predominantly female (53.1%) and White (66.2%), and the average age of the sample was 50.2 ± 17.2 years. Quantitatively and qualitatively, there were several common strategies such as activity/rest, talking to others, and positive thinking used by adults with cardiovascular disease to maintain, monitor, and manage their psychological health when these data were mixed. Specific psychological self-care behaviours differed substantively across categories of level of depressive symptoms and adequacy of self-care. CONCLUSION: Greater parity between physical and psychological aspects of self-care should be integrated into self-care research, theories and practice.