Adverse Impact of COVID-19 on Hopelessness Levels in Patients With Ischemic Heart Disease
Susan L Dunn1, Holli A DeVon, Eileen G Collins
1Author Affiliations: University of Illinois Chicago, Chicago, Illinois (Dr Dunn, Dr Collins, Ms Luong, Mr Hrynyk, Dr Cajita, and Dr Tintle); and University of California, Los Angeles, California (Dr DeVon).
Insights
The COVID-19 pandemic increased hopelessness in ischemic heart disease patients, with anxiety mediating this effect. Factors like food access and social support also contributed to feelings of hopelessness.
Area of Science:
- Cardiology
- Psychiatry
- Public Health
Background:
- The COVID-19 pandemic significantly impacted global mental health.
- Ischemic heart disease (IHD) patients face unique challenges and potential mental health declines during health crises.
Purpose of the Study:
- To quantify the association between the perceived impact of COVID-19 and hopelessness in patients with IHD.
- To identify psychological and social mediators influencing this relationship.
Main Methods:
- A cohort of 110 IHD patients was studied post-hospitalization between 2020 and 2023.
- Data collected included perceived COVID-19 impact, hopelessness, anxiety, social support, quality of life, and well-being.
- Linear models analyzed associations between variables.
Main Results:
- Hopelessness showed a modest association with the perceived impact of COVID-19 (state r=0.23, trait r=0.30).
- Anxiety emerged as a significant mediator, explaining 66% of the state and 50% of the trait hopelessness relationship.
- Factors such as food access, employment, social support, and stress were linked to increased hopelessness.
Conclusions:
- This study highlights a significant relationship between perceived COVID-19 impact and hopelessness in IHD patients, mediated by anxiety.
- Pandemic-related socioeconomic factors (food access, employment, social support) and stress exacerbate hopelessness in this vulnerable population.
- Further investigation into the interplay between hopelessness and anxiety in IHD patients during pandemics is warranted.
Purpose:
The coronavirus disease-2019 (COVID-19) pandemic negatively impacted mental health outcomes. This study aimed to 1) quantify the relationship between perceived impact of COVID-19 and hopelessness in patients with ischemic heart disease (IHD) and 2) identify potential mediators of the relationship.
Methods:
Participants (n = 110) were recruited from 1 hospital in the Midwestern United States. Data on the perceived impact of COVID-19, state and trait hopelessness, depression, perceived social support (PSS), health-related quality of life (HRQoL), and well-being were collected 2 weeks post-hospitalization from 2020 to 2023. Linear models were used to evaluate associations between variables in adjusted and unadjusted models.
Results:
Most participants were male (69%), non-Hispanic White (95%), married (64%), and with some college education (66%). Hopelessness showed a modest association with perceived COVID-19 impact (state = 0.23; trait = 0.30), as did anxiety (0.40), HRQoL (0.20), PSS (-0.24), fatigue (0.25), and pain interference (0.25), in adjusted and unadjusted models. Food access, family income/employment, social support access, and stress were associated with hopelessness and perceived COVID-19 impact. The strongest evidence for mediation between hopelessness and perceived COVID-19 impact was anxiety (66% mediation state; 50% mediation trait).
Conclusions:
In this first study to report hopelessness levels in patients with IHD during the COVID-19 pandemic, the relationship between hopelessness and perceived COVID-19 impact was supported and mediated by anxiety. During a pandemic, food access, social support, family income/employment, and stress in patients with IHD may increase feelings of hopelessness. Further research is required to examine the hopelessness and anxiety relationship.
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