Debra Moser's self-care intervention program focuses on the emotional well-being of caregivers and family of patients with cardiac disease. Clinical depression impacts 25 percent of all patients who suffer from cardiac disease, compared with 2 to 3 percent of the general population. 

Depressive symptoms, which can have debilitating effects similar to clinical depression, are observed in 75 percent of cardiac patients who are hospitalized. 

According to University of Kentucky College of Nursing professor Debra Moser, depression and symptoms of depression can impede self-care interventions, which are especially important for maintaining the well-being of cardiac patients. Depression affects both the patient's ability to conduct essential self-care activities and the caregiver's ability to assist in a self-care intervention. 

"Anybody with depression or depressive symptoms has a terrible time adhering to the self-care activities they need, like taking medication, engaging in physical activity, eating whatever diet is prescribed to you," Moser said. "People who are depressed don't have the energy or the will to engage in those sorts of activities." 

To prevent psychological barriers caused by depression, Moser has integrated cognitive behavioral therapy in self-care interventions for cardiac patients. This therapy prevents the onset of depression by helping patients work through negative or erroneous thoughts about their condition. 

"People who have depression often turn a simple event into a catastrophe that is going to destroy their life," Moser said. "It's just re-conceptualizing a situation, sort of reframing it so that you see how to work through a formerly insurmountable barrier." 

Moser's self-care intervention program also focuses on the emotional well-being of the caregiver and entire family surrounding the patient. Based on the theory of emotional contagion, depression or depressive symptoms can be easily transferred from one member of a relationship or household to another. Because depressive symptoms are common in cardiac patients, self-care programs must also consider the emotional well-being of the caregiver. 

"When we provide interventions to caregivers, they get the skills and the knowledge to not be so burdened by the condition, but they also get some direct attention for their own health, for their own depressive symptoms, for their own quality of life," Moser said. "And really the act of providing an outlet to caregivers is really found to be helpful just in improving their own psychological health."