Gratitude Intervention for Cardiac Rehabilitation Patients
Condition: Cardiovascular Diseases
MeSH terms: Cardiovascular Diseases
Study type: Interventional

Summary: 
      This is a single-center cohort study of patients in a cardiac rehabilitation program with a
      diagnosis of cardiovascular disease (CVD), including heart failure, coronary artery disease,
      post myocardial infarction, post percutaneous coronary intervention and post cardiac surgery.
      Participants will be randomized to the gratitude intervention or an attention control group.
      This study is a pilot study to determine the feasibility and acceptability of administering
      the gratitude intervention in a cardiac rehabilitation setting.
    

Detailed description: 
      Nursing-led interventions of chronic diseases, including cardiovascular disease (CVD), have
      been proved to be successful. Appropriately trained nurses produce high-quality care and good
      health outcomes for patients equivalent to that achieved by physicians with higher levels of
      patient satisfaction. CVD, including coronary artery disease and heart failure, is a major
      and rapidly growing public health problem. Despite advances in its treatment, it remains the
      leading cause of death in the U.S. Furthermore, the prevalence of CVD in adults is estimated
      to continue to rise and that by 2035, 45.1% of the U.S. population will have some form of CVD
      with total costs expected to reach $1.1 trillion with direct medical costs projects to reach
      $748.7 billion. Therefore, novel preventive efforts are needed.

      Negative psychological states, including depression and pessimism (negative future
      expectation), have been linked with poor CVD outcomes. Despite the fact that optimism
      (positive future expectation) and other positive affective states have been associated with
      superior cardiovascular outcomes, little research has focused on interventions designed to
      increase positive psychological states in patients at risk for CVD. In the current trial,
      patients in an academic medical center cardiac rehabilitation program will be approached.
      Cardiac rehabilitation is an integral component in the treatment of patients with
      cardiovascular disease including coronary artery disease, heart failure with reduced ejection
      fraction, following heart valve surgery or cardiac transplantation.

      One of its core components is psychological support and management. In this nursing-led
      study, participants will be randomized to a gratitude intervention or an attention control
      group. The gratitude intervention, which encourages participants to notice and appreciate the
      positive features of life, is based on the work of Emmons and McCullough, and involves
      participants writing (or if unable to write, speaking) things for which they are grateful.
      Much of the existing research on gratitude (noticing and appreciating the positive features
      of life) has focused primarily on outcomes associated with psychological factors and social
      interactions.

      The primary aim of this feasibility study will be to determine if a gratitude intervention is
      acceptable and feasible in a cohort of patients attending cardiac rehabilitation.
    

Intervention name(s): Attention Control; Gratitude Journaling
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Participants in this group will be asked to recall 3 to 5 events from the prior day of the intervention and write, or if unable to write, speak about these events.; The gratitude journaling intervention involves participants writing or speaking 3-5 things for which they are grateful and focusing on these attributes. Participants will do this weekly for 12 weeks.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Supportive Care
Keywords: depression; pessimism; gratitude; nursing