posted December 2, 2003

Research on Heart Attack Recovery

A federal grant is supporting a Hope College nursing professor's research into the way that hopelessness and depression may affect the recovery of patients who have suffered a heart attack.

Susan Dunn, assistant professor of nursing, is studying whether or not increased levels of hopelessness and depression have a negative effect on how heart attack patients recover. She is exploring in particular whether or not they stay with their exercise rehabilitation programs and their physical functioning in the months after leaving the hospital.

Her goal is to provide health care professionals with information that will help them serve patients more effectively. "That's the ultimate hope - that we as nurses could identify patients who are at risk and that we could intervene," she said.

Her two-year project has received $50,000 in support through the National Institute of Nursing Research, part of the National Institutes of Health.

She is conducting her investigation in conjunction with a large-scale research project based at Michigan State University: "Patient Decision Support and Coaching Project: Heart After Hospital Recovery Planner" (HARP). The multidisciplinary HARP study involves a team of more than a dozen researchers, and is headed by Dr. Margaret Holmes-Rovner, who is section chief and professor of health services research in the College of Human Medicine at MSU. Dunn began working with the team while pursuing doctoral coursework at the university in 2001.

Earlier studies, Dunn said, have found that hopelessness and depression can lead to heart trouble, but the role of both in the aftermath of a heart attack is less well understood. She is also interested in considering whether or not hopelessness is distinct from depression in its effects."Some of the literature indicates that the two overlap," she said. "Other research seems to indicate that depression and hopelessness are two different variables."

Dunn is following the progress of some 550 people who have suffered heart attacks, all selected from among patients treated at four hospitals on the east side of the state. She has already started analysis of baseline data, and has found that the heart attack patients are significantly more depressed and also feel more hopeless than the average population.

As the project continues through the spring of 2005, she'll measure whether or not the emotions correlate to ongoing heart trouble. If so, she hopes her work will serve as a foundation for developing strategies to prevent hopelessness and depression in heart attack patients and to promote their physical recovery.Although she has been involved in the HARP study for two years, Dunn's interest in the topic goes back much farther.

"My background is cardiovascular nursing," she said. "I've worked with cardiovascular patients for 15 years. I've always been interested in the psychological response to their illness and also how psychological states might even contribute to heart disease."

Dunn has been a member of the Hope faculty since 1997. She teaches courses in research in nursing, and has been using her project as an example of the process.

"I incorporate what I'm doing into what I'm teaching," she said. "It gives us a chance to talk about a real project that is currently happening, and to see how it's evolving."