title: Positive affect, anhedonia, and compliance with self-care in patients with chronic heart failure.
abstract: OBJECTIVE
  Optimal self-care is crucial in patients with chronic heart failure (HF). While the focus of research has been on negative mood states, adequate psychological resources may be required to successfully engage in HF self-care. Therefore, the longitudinal associations of multiple positive affect measures in explaining HF self-care including consulting behavior were examined while adjusting for depressive symptoms and potential covariates (e.g., disease severity).
  
  
  METHODS
  In this prospective cohort study, 238 patients (mean age: 66.9 ± 8.6 years, 78% men), with chronic HF completed questionnaires at baseline and 1-year follow-up. Positive affect was assessed with the Positive and Negative Affect Schedule (PANAS) and the Global Mood Scale (GMS). Anhedonia, i.e. diminished interest or pleasure, was assessed with a subscale of the Hospital Anxiety and Depression Scale (HADS). The 9-item European Heart Failure Self-care Behaviour scale was completed to assess HF self-care including consultation behavior.
  
  
  RESULTS
  Linear mixed modeling results showed that anhedonia was most strongly associated with both poor self-care (estimate=-.72, P<.001) and consulting behavior (estimate=-.44, P<.001) over time, after adjustment for covariates and depressive symptoms. GMS positive affect was related to better HF self-care adjusting for standard depressive symptoms but not when adjusting for anhedonia. PANAS positive affect was not independently related to self-care.
  
  
  CONCLUSIONS
  Anhedonia was associated with worse compliance with self-care among chronic HF patients over time, irrespective of disease severity and depression. Associations between positive affect and self-care were dependent on the measures used in multivariable analyses.
authors.affiliation: Center of Research on Psychology in Somatic Diseases (CoRPS), Tilburg University, Tilburg, The Netherlands.
authors.forename: Dionne
authors.initials: D
authors.lastname: Kessing
authors.affiliation: Center of Research on Psychology in Somatic Diseases (CoRPS), Tilburg University, Tilburg, The Netherlands.
authors.forename: Aline J
authors.initials: AJ
authors.lastname: Pelle
authors.affiliation: Center of Research on Psychology in Somatic Diseases (CoRPS), Tilburg University, Tilburg, The Netherlands.
authors.forename: Nina
authors.initials: N
authors.lastname: Kupper
authors.affiliation: Department of Cardiology, St. Elisabeth Hospital, Tilburg, The Netherlands.
authors.forename: Balázs M
authors.initials: BM
authors.lastname: Szabó
authors.affiliation: Center of Research on Psychology in Somatic Diseases (CoRPS), Tilburg University, Tilburg, The Netherlands. Electronic address: j.denollet@tilburguniversity.edu.
authors.forename: Johan
authors.initials: J
authors.lastname: Denollet
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000339:Affect; D000368:Aged; D059445:Anhedonia; D002908:Chronic Disease; D003863:Depression / Q000209:etiology; D005260:Female; D006333:Heart Failure / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D011446:Prospective Studies; D012648:Self Care / Q000523:psychology* / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires
keywords: Anhedonia; Compliance; Depression; Heart failure; Positive affect; Self-care