Patient hopelessness linked to poor cardiac rehab, researchers find

October 22, 2009

(PhysOrg.com) -- Feelings of hopelessness lead to decreased participation in rehabilitation for patients recovering from cardiac events such as a heart attack, according to a team of researchers led by a Michigan State University College of Nursing alumna.

The findings show physicians need to address emotional issues such as hopelessness as well as physical symptoms when creating successful rehabilitation plans, said Susan Dunn, chairperson of the Department of Nursing at Hope College and a member of the first class of doctoral graduates from MSU's College of Nursing.

"While hopelessness has been associated with a higher risk of fatal and nonfatal coronary heart disease, very few studies have examined hopelessness after a cardiac event," Dunn said. "We found interventions focused on the prevention and treatment of hopelessness symptoms may potentially contribute to improved recovery of heart patients."

Working with Dunn on the project were MSU researchers Manfred Stommel and William Corser from the College of Nursing and Margaret Holmes-Rovner from the Center for Ethics and Humanities in the Life Sciences.

As part of the study, 207 patients who suffered a cardiac event were interviewed at three and eight months after hospital discharge; they were given measures to gauge hopelessness and depression. While hopelessness persisted among many patients and was an independent predictor of lower exercise participation, depression showed no such influence.

"The results demonstrate the complexity of health outcomes of chronically ill patients in contemporary care environments," Corser said. "Health care practitioners must have an understanding of hopelessness to diagnose its presence and identify its potential effect on exercise participation."

Dunn, who graduated from the MSU College of Nursing's doctoral program in 2005, has been working with hopelessness and depression among patients with cardiac events for some time.

"This area of research is vital, because while depression is often seen among patients recovering from illness, the symptoms are usually temporary," she said. "Hopelessness seems to capture a more permanent inability to recover psychologically."

Provided by Michigan State University (news : web)