Clinical trial NCT04498975: Exploring Potential Associations Between Rurality and Hopelessness in IHD Patients
Official title: Exploring Potential Associations Between Rurality and Hopelessness in IHD Patients
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Cardiac Disease
Mental Health Issue
Keywords: Rurality
Lead sponsor: Dordt University
Sponsor class: OTHER
Collaborators: name: Sanford Health
name: Avera McKennan Hospital & University Health Center
name: University of Illinois at Chicago
First posted: 2020-08-05
Enrollment: 125
Sex: ALL
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Hospitalized individuals

Brief summary: Hopelessness is associated with 3.4 times increased risk of mortality or nonfatal myocardial infarction in patients with ischemic heart disease (IHD), independent of depression. Hopelessness has been identified in 27-52% of patients with IHD and can persist for up to 12 months after hospital discharge. Hopelessness, a negative outlook and sense of helplessness toward the future, can be a temporary response to an event (state) or a habitual outlook (trait). Hopelessness is associated with decreased physical functioning and lower physical activity (PA) levels in individuals with IHD. Low levels of PA independently contribute to increased death and adverse events in patients with IHD. Rates of PA in IHD patients continue to be unacceptably low in both hospital-based cardiac rehabilitation and home settings. Compounding this issue is often the symptom of hopelessness. The links among hopelessness, PA and mortality and morbidity for patients with IHD remain largely unknown, especially in rural and minority IHD patients. The purpose of this study is to delineate differences in hopelessness between urban and rural patients with IHD, as well as between racial minority, including Hispanic and Native American, and White patients with IHD. Potential mediation of urbanicity and race/ethnicity by social connectedness, a key variable in rural settings, will also be examined. A 6-month longitudinal study will be conducted at Sanford Heart Hospital and Avera Health in Sioux Falls, South Dakota. Hopelessness will be measured using the State-Trait Hopelessness Scale. The results of this study have potential to transform nursing practice by providing a better understanding of hopelessness in IHD patients and informing future exercise rehabilitation studies and interventions in rural and minority populations.


Eligibility criteria: Inclusion Criteria:

* Myocardial infarction or unstable angina or having undergone a percutaneous coronary intervention or coronary artery bypass surgery
* ≥ 18 years
* planned discharge home
* cognitive and physical ability to complete the study measures.

Exclusion Criteria:

* None

Primary outcomes:
measure: State and Trait levels of Hopelessness
timeFrame: Six-month
Secondary outcomes:
measure: Participation (yes/no) and Levels (frequency; vigor) of Exercise
timeFrame: Six-month
Other outcomes:
Locations:
city: Sioux Falls
country: United States
facility: Avera Health
state: South Dakota
city: Sioux Falls
country: United States
facility: Sanford Health
state: South Dakota
Study officials:
affiliation: Dordt University
name: Nathan Tintle
role: PRINCIPAL_INVESTIGATOR
References:
citation: Bomgaars D, Jensen GA, White LL, Van De Griend KM, Visser AK, Goodyke MP, Luong A, Tintle NL, Dunn SL. Investigating Rurality as a Risk Factor for State and Trait Hopelessness in Hospitalized Patients With Ischemic Heart Disease. J Am Heart Assoc. 2021 Sep 7;10(17):e020768. doi: 10.1161/JAHA.121.020768. Epub 2021 Sep 1.