Psychological distress and its management among people living with hypertension in Ghana

Abstract

Hypertension affects a significant number of people globally, with the majority in low- and middle-income countries. Psychological distress such as anxiety, depression and stress, may occur as a consequence of hypertension. However, these distresses among people living with hypertension remain undiagnosed and untreated in Ghana. We assessed the prevalence and management of psychological distress among people living with hypertension, receiving care in selected health facilities in Ghana. The study employed a concurrent mixed-methods approach. A cross-sectional study was used to assess the prevalence of psychological distress and associated factors among 500 participants living with hypertension, using DASS-21 and some self-developed questions. Indepth interviews with healthcare professionals explored management approaches of psychological distress. Descriptive and logistic regression analyses were used to analyze quantitative data and thematic analysis was used for the qualitative data. We found out that the prevalence of psychological distress including symptoms of depression, anxiety and stress was 80.2%, 89.2%, and 70.6% respectively with 69.8% having multi-morbidity. Age [aOR = 0.19, 95%CI = 0.07–0.52], religion [aOR = 2.88, 95%CI = 1.16–7.13], ethnicity [aOR = 0.28, 95%CI = 0.14–0.57] occupation [aOR = 0.34, 95%CI = 0.13–0.85, p = 0.023], and difficulty adhering to medication [aOR = 2.05, 95%CI = 1.13–3.73] were factors associated with psychological distress. General assessment, family support, counseling, education and medication were the management approaches adopted by the health professionals. Psychological distress was highly prevalent among people living with hypertension with many individuals experiencing multiple conditions. Factors such as age, religion, ethnicity, occupation and medication adherence were associated with psychological distress. Strengthening psychosocial support, counseling and education is essential to improve mental health outcomes and advance progress toward SDG 3.