title: Hopelessness and its effect on cardiac rehabilitation exercise participation following hospitalization for acute coronary syndrome.
abstract: OBJECTIVE
  Hopelessness has been associated with a higher risk of fatal and nonfatal coronary heart disease, yet very few studies have examined hopelessness after a cardiac event. This investigation examined hopelessness as an independent predictor of participation in a hospital-based cardiac rehabilitation exercise program.
  
  
  METHODS
  A total of 207 patients with acute coronary syndrome were interviewed at 3 and 8 months after hospital discharge. Measures included 1 factor of the Beck Hopelessness Scale, the Center for Epidemiological Studies Depression Scale, the Activity Status Index, the Charlson Comorbidity Index, a sociodemographic variables tool, and a cardiac rehabilitation exercise participation questionnaire.
  
  
  RESULTS
  Random-effects logistic regression analysis revealed that hopelessness persisted over time and was an independent predictor of lower exercise participation. In contrast, depression showed no significant influence on exercise participation.
  
  
  CONCLUSIONS
  Study findings suggest the importance of assessing hopelessness in patients with acute coronary syndrome and identifying approaches to exercise recommendations that directly address hopelessness. Interventions focused on the prevention and treatment of hopelessness symptoms may contribute to improved recovery of patient with acute coronary syndrome.
authors.affiliation: Department of Nursing, Hope College, Holland, Michigan 49423, USA. dunns@hope.edu
authors.forename: Susan L
authors.initials: SL
authors.lastname: Dunn
authors.forename: Manfred
authors.initials: M
authors.lastname: Stommel
authors.forename: William D
authors.initials: WD
authors.lastname: Corser
authors.forename: Margaret
authors.initials: M
authors.lastname: Holmes-Rovner
mesh_terms: D054058:Acute Coronary Syndrome / Q000534:rehabilitation*; D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003327:Coronary Disease / Q000534:rehabilitation; D003863:Depression; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013315:Stress, Psychological; D011795:Surveys and Questionnaires; D016896:Treatment Outcome