Comorbidities are associated with state hopelessness in adults with ischemic heart disease
Holli A DeVon1, Nathan Tintle2, Ulf G Bronas3
1School of Nursing; University of California Los Angeles, USA.
Insights
Comorbidities in ischemic heart disease (IHD) patients are linked to higher hopelessness. Assessing and addressing hopelessness in these patients may improve long-term outcomes.
Area of Science:
- Cardiology
- Psychiatry
- Gerontology
Background:
- Comorbidities and hopelessness are independent risk factors for mortality in adults with ischemic heart disease (IHD).
- Understanding the interplay between specific health conditions and psychological states is crucial for managing IHD patients.
Purpose of the Study:
- To investigate the association between comorbidities and both state and trait hopelessness in individuals hospitalized for IHD.
- To explore the influence of specific medical conditions and hopelessness levels on IHD patient outcomes.
Main Methods:
- Participants (n=132) completed the State-Trait Hopelessness Scale.
- Charlson Comorbidity Index (CCI) scores were calculated from medical records.
- Linear models were used to analyze the relationship between CCI scores and hopelessness levels, adjusting for demographic factors.
Main Results:
- A higher Charlson Comorbidity Index (CCI) score was positively associated with both state and trait hopelessness in unadjusted analyses.
- The association between CCI and state hopelessness remained significant after adjusting for demographic characteristics.
- No significant differences in findings were observed across age, sex, education level, or IHD type.
Conclusions:
- Hospitalized IHD patients with a greater number of comorbidities may experience higher levels of state hopelessness.
- Targeted assessments and brief cognitive interventions could help identify and manage state hopelessness in IHD patients.
- Addressing state hopelessness is important due to its association with poorer long-term outcomes in IHD.
Background:
In adults with ischemic heart disease (IHD), comorbidities and hopelessness are independently associated with increased risk of mortality.
Objectives:
To determine if comorbidities were associated with state and trait hopelessness and explore the influence of specific conditions and hopelessness in individuals hospitalized for IHD.
Methods:
Participants completed the State-Trait Hopelessness Scale. Charlson Comorbidity Index (CCI) scores were generated from the medical record. A chi-squared test was used to examine differences in 14 diagnoses included in the CCI by CCI severity. Unadjusted and adjusted linear models were used to explore the relationship between hopelessness levels and the CCI.
Results:
Participants (n=132) were predominantly male (68.9%), with a mean age of 62.6 years, and majority white (97%). The mean CCI was 3.5 (range 0-14), with 36.4% having a score of 1-2 (mild), 41.2% with a score of 3-4 (moderate) and 22.7% with a score of ≥5 (severe). The CCI was positively associated with both state (β=0.03; 95% CI 0.01, 0.05; p=0.002) and trait (β=0.04; 95% CI 0.01, 0.06; p=0.007) hopelessness in unadjusted models. The relationship for state hopelessness remained significant after adjusting for multiple demographic characteristics (β=0.03; 95% CI 0.01, 0.05; p=0.02), while trait hopelessness did not. Interaction terms were evaluated, and findings did not differ by age, sex, education level, or diagnosis/type of intervention.
Conclusion:
Hospitalized individuals with IHD with a higher number of comorbidities may benefit from targeted assessment and brief cognitive intervention to identify and ameliorate state hopelessness which has been associated with worse long-term outcomes.
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