title: Cognitive therapy improves three-month outcomes in hospitalized patients with heart failure.
abstract: BACKGROUND
  Patients with heart failure (HF) experience depressive symptoms that contribute to poorer outcomes. We tested the effects of a brief cognitive therapy intervention on depressive symptoms, negative thinking, health-related quality of life, and cardiac event-free survival.
  
  
  RESULTS
  Hospitalized patients with depressive symptoms (n = 41, 66 ± 11 years, 45% female, 81% New York Heart Association Class III/IV) were randomly assigned to control group or a brief, nurse-delivered cognitive therapy intervention, delivered during hospitalization and followed by a 1-week booster phone call. Depressive symptoms, negative thinking, and health-related quality of life were measured at 1 week and 3 months. Cardiac event-free survival was assessed at 3 months. Mixed models repeated measures analysis of variance, Kaplan-Meier, and Cox regression were used for data analysis. There were significant improvements in depressive symptoms and health-related quality of life in both groups but no interactions between group and time. The control group had shorter 3-month cardiac event-free survival (40% versus 80%, P < .05) and a 3.5 greater hazard of experiencing a cardiac event (P = .04) than the intervention group.
  
  
  CONCLUSIONS
  Nurses can deliver a brief intervention to hospitalized patients with heart failure that may improve short-term, event-free survival. Future research is needed to verify these results with a larger sample size.
authors.affiliation: University of Kentucky College of Nursing, Lexington, KY 40536-0232, USA. rdekker@uky.edu
authors.forename: Rebecca L
authors.initials: RL
authors.lastname: Dekker
authors.forename: Debra K
authors.initials: DK
authors.lastname: Moser
authors.forename: Ann R
authors.initials: AR
authors.lastname: Peden
authors.forename: Terry A
authors.initials: TA
authors.lastname: Lennie
mesh_terms: D000368:Aged; D015928:Cognitive Behavioral Therapy; D003863:Depression; D005260:Female; D006333:Heart Failure / Q000401:mortality / Q000523:psychology* / Q000628:therapy*; D006760:Hospitalization; D006801:Humans; D007629:Kentucky; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011788:Quality of Life; D011795:Surveys and Questionnaires; D016019:Survival Analysis; D016896:Treatment Outcome