Perceptions of healthcare workers on linkage between depression and hypertension in northern Ghana: a qualitative study - PubMed

Perceptions of healthcare workers on linkage between depression and hypertension in northern Ghana: a qualitative study

Dorothy Adu-Amankwah et al. Glob Ment Health (Camb). 2024.

Abstract

Hypertension and depression are increasingly common noncommunicable diseases in Ghana and worldwide, yet both are poorly controlled. We sought to understand how healthcare workers in rural Ghana conceptualize the interaction between hypertension and depression, and how care for these two conditions might best be integrated. We conducted a qualitative descriptive study involving in-depth interviews with 34 healthcare workers in the Kassena-Nankana districts of the Upper East Region of Ghana. We used conventional content analysis to systematically review interview transcripts, code the data content and analyze codes for salient themes. Respondents detailed three discrete conceptual models. Most emphasized depression as causing hypertension: through both emotional distress and unhealthy behavior. Others posited a bidirectional relationship, where cardiovascular morbidity worsened mood, or described a single set of underlying causes for both conditions. Nearly all proposed health interventions targeted their favored root cause of these disorders. In this representative rural Ghanaian community, healthcare workers widely agreed that cardiovascular disease and mental illness are physiologically linked and warrant an integrated care response, but held diverse views regarding precisely how and why. There was widespread support for a single primary care intervention to treat both conditions through counseling and medication.

Keywords: community-based initiatives; depression; developing countries; healthcare workers; hypertension.

Conflict of interest statement

D.J.H. reports support from Hess Corporation, who was not involved in any way in the creation of this manuscript or the conduct of this research. No other author has any potential conflict to disclose.

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