Article

PURPOSE: Hopelessness is associated with increased adverse events and decreased
survival in patients with coronary heart disease (CHD).
The purpose of this
research was to examine the effect of regular home- and hospital-based cardiac
rehabilitation (CR) exercise on hopelessness levels in patients with CHD,
hypothesizing that increased exercise in either setting would lead to decreased
state hopelessness. METHODS: A descriptive longitudinal design was used at a
large teaching hospital in Michigan. A total of 324 patients provided data during
hospitalization and at least 1 followup time point (3, 8, and 12 months).
RESULTS: The patients had persistent, modest levels of state and trait
hopelessness across all time points. Among home exercisers with moderate to
severe state hopelessness at baseline, both mean state
(P = .002) and trait (P =
.02) hopelessness were reduced at later time points compared with those who quit
or did not start exercise. Multivariable models showed that when individuals had
moderate to severe baseline state hopelessness, home exercise remained associated
with decreases in state hopelessness compared with no exercise, even after
adjusting for hospital exercise, depression, and demographic variables.
CONCLUSIONS: Exercise may be effective in reducing moderate to severe
hopelessness in patients with CHD. Moderate to severe baseline state hopelessness
was a predictor of attrition in this cohort, especially for home exercisers, but
this was mediated in hospital-based programs. Further research is needed to
determine how hopeless individuals can be encouraged to exercise and whether
home- or a hospital-based CR exercise is superior in impacting hopelessness.

Langue : ANGLAIS