Susan Dunn of the Hope College nursing faculty is lead author of a study that has found that home exercise can ease hopelessness in people with coronary heart disease, research announced during a major American Heart Association (AHA) conference on Tuesday, Nov. 18.
The study was shared during the AHA’s Scientific Sessions 2014, held in Chicago, Illinois, on Saturday-Wednesday, Nov. 15-19. Scientific Sessions is the leading cardiovascular meeting in the country with more than 17,000 professionals attending annually, and more than 22,000 total attendees, as reported by the Healthcare Convention and Exhibitor’s Association.
Dunn was one of approximately 15 research presenters, out of thousands at the event, who were selected for a taped interview. The AHA’s news release about the research and the interview can be viewed at http://newsroom.heart.org/news.
The description and additional information which follows is shared from the AHA’s release:
Feeling hopeless—pessimism and a sense of helplessness about the future—can be dangerous because it can discourage people from taking healthful steps such as exercising, losing weight or quitting smoking, said Dunn, Ph.D., R.N. People with hopelessness may also suffer from depression, which is marked by a loss of interest in activities they normally enjoy.
“For the first time, we show the beneficial effect of exercise in helping patients to feel more hopeful. With home exercise, patients are likely thinking more positively about the future and feeling more capable of making positive changes for a healthy lifestyle,” Dunn said.
Past studies have linked the feeling of hopelessness to the development and worsening of coronary heart disease and a higher risk of complications and death. Yet, little research has been done on helping these patients and many healthcare professionals overlook things like mental state, attitude, perspective and outlook as aspects of patient care.
The new study involved 324 patients (average age 66 years, 33 percent women and 93 percent white) with coronary heart disease.
Researchers developed an instrument to measure feelings of hopelessness: “state” hopelessness, which is how pessimistic and helpless patients feel currently, and “trait” hopelessness, which captures how patients typically feel over much longer periods.
At the study’s outset, while still in the hospital, 24 percent of the patients had current feelings of hopelessness, 28 percent expressed long-term feelings of hopelessness and 30 percent had both types, at moderate to severe levels.
During a year, those who walked or biked at home at least three days a week had a 12 percent reduction in state hopelessness scores— even when considering other relevant circumstances such as age, participation in hospital-based exercise and factors of depression. This reduction was statistically significant and so was not due to chance.
The researchers were surprised to find that hospital-based cardiac rehabilitation exercise didn’t impact current hopelessness. Perhaps the initiative required to exercise at home increased patients’ sense of empowerment about their health, Dunn said.
“Individuals with trait hopelessness feel chronically helpless about many areas of their life,” Dunn said, suggesting that longer-term hopelessness may be harder to treat.
A key limitation of the small study was that some patients who felt the most hopeless dropped out over time. Also, further research is needed to examine hopelessness and exercise in racially diverse groups.
Healthcare providers need to assess the presence and severity of hopelessness in patients before hospital discharge, Dunn said.
“All patients should be encouraged to participate in a regular exercise program,” she said. “Special encouragement is needed for patients who are moderately to severely hopeless, as they may be the most vulnerable and the least likely to exercise, yet benefit the most.”
Co-authors are Maureen Dunn, Ph.D. [a professor of kinesiology at Hope]; Nicole Rieth, B.S.N., R.N. [a 2009 Hope graduate]; Jacob Clark, B.S. [a Dordt College graduate]; and Nathan Tintle, Ph.D. [a former member of the Hope mathematics faculty now teaching mathematics at Dordt College]. Author disclosures are on the manuscript.
The Howard Hughes Medical Institute, Great Lakes Colleges Association and Kappa Epsilon Chapter-at-Large of Sigma Theta Tau Honor Society of Nursing funded the study.