The association between hope, marital status, depression and persistent pain in men and women following cardiac surgery

Ann Kristin Bjørnnes, Monica Parry, Irene Lie, Ragnhild Falk, Marit Leegaard, Tone Rustøen, Ann Kristin Bjørnnes, Monica Parry, Irene Lie, Ragnhild Falk, Marit Leegaard, Tone Rustøen

Abstract

Background: Cardiac surgery is a major life event, and outcomes after surgery are associated with men's and women's ability to self-manage and cope with their cardiac condition in everyday life. Hope is suggested to impact cardiac health by having a positive effect on how adults cope with and adapt to illness and recommended lifestyle changes.

Methods: We did a secondary analysis of 416 individuals (23% women) undergoing elective coronary artery bypass graft and/or valve surgery between March 2012 and September 2013 enrolled in randomized controlled trial. Hope was assessed using The Herth Hope Index (HHI) at three, six and 12 months following cardiac surgery. Linear mixed model analyses were performed to explore associations after cardiac surgery between hope, marital status, depression, persistent pain, and surgical procedure.

Results: For the total sample, no statistically significant difference between global hope scores from 3 to 12 months was observed (ranging from 38.3 ± 5.1 at 3 months to 38.7 ± 5.1 at 12 months), and no differences between men and women were observed at any time points. However, 3 out of 12 individual items on the HHI were associated with significantly lower scores in women: #1) I have a positive outlook toward life, #3) I feel all alone, and #6) I feel scared about my future. Over the study period, diminished hope was associated with older age, lower education, depression prior to surgery, and persistent pain at all measurement points. Isolated valve surgery was positively associated with hope. While neither sex nor marital status, as main effects, demonstrated significant associations with hope, women who were divorced/widowed/single were significantly more likely to have lower hope scores over the study period.

Conclusion: Addressing pain and depression, and promoting hope, particularly for women living alone may be important targets for interventions to improve outcomes following cardiac surgery.

Trial registration: Clinical Trials gov Identifier: NCT01976403 . Date of registration: November 28, 2011.

Keywords: Cardiac surgery; Depression; Hope; Marital status; Persistent pain.

Conflict of interest statement

Ethics approval and consent to participate

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee. All eligible participants received oral and written information about the study and provided written informed consent to participate. Participants were informed that they could withdraw from the study at any time during the study period without giving reasons. Ethics approval was obtained from Regional Committee for Medical Research Ethics in Eastern Norway (no. 2011/2012 A) and Social Science Data Services at Oslo University Hospital (no. 2012/16916). Clinical Trials gov Identifier: NCT0197640, registered November 28. 2011.

Consent for publication

Not applicable

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Participant flow through the study

References

    1. Benjamin EJ, Blaha MJ, Chiuve SE, Cushman M, Das SR, Deo R, de Ferranti SD, Floyd J, Fornage M, Gillespie C, et al. Heart disease and stroke statistics—2017 update: a report from the American Heart Association. Circulation. 2017;135(10):e146–e603. doi: 10.1161/CIR.0000000000000485.
    1. Szelkowski LA, Puri NK, Singh R, Massimiano PS. Current trends in preoperative, intraoperative, and postoperative care of the adult cardiac surgery patient. Curr Probl Surg. 2015;52(1):531–569. doi: 10.1067/j.cpsurg.2014.10.001.
    1. Lie I, Bunch EH, Smeby NA, Arnesen H, Hamilton G. Patients' experiences with symptoms and needs in the early rehabilitation phase after coronary artery bypass grafting. J Cardiovasc Nurs. 2012;11(1):14–24. doi: 10.1016/j.ejcnurse.2010.09.004.
    1. Jaarsma T, Årestedt KF, Mårtensson J, Dracup K, Strömberg A. The European heart failure self-care behaviour scale revised into a nine-item scale (EHFScB-9): a reliable and valid international instrument. Eur J Heart Fail. 2009;11(1):99–105. doi: 10.1093/eurjhf/hfn007.
    1. Snyder CR. Hope theory: rainbows in the mind. Psychol Inq. 2002;13(4):249–275. doi: 10.1207/S15327965PLI1304_01.
    1. Feldman DB, Sills JR. Hope and cardiovascular health-promoting behaviour: education alone is not enough. Psychol Health. 2013;28(7):727–745. doi: 10.1080/08870446.2012.754025.
    1. Beckie TM, Beckstead JW, Webb MS. Modeling women’s quality of life after cardiac events. West J Nurs Res. 2001;23(2):179–194. doi: 10.1177/019394590102300206.
    1. Boehm JK, Peterson C, Kivimaki M, Kubzansky LD. Heart health when life is satisfying: evidence from the Whitehall II cohort study. Eur Heart J. 2011;32(21):2672–2677. doi: 10.1093/eurheartj/ehr203.
    1. Kim ES, Hagan KA, Grodstein F, DeMeo DL, De Vivo I, Kubzansky LD. Optimism and cause-specific mortality: a prospective cohort study. Am J Epidemiol. 2016;185(1):21–29. doi: 10.1093/aje/kww182.
    1. Dufault K, Martocchio BC. Symposium on compassionate care and the dying experience. Hope: its spheres and dimensions. Nurs Clin North Am. 1985;20(2):379–391.
    1. Schaufel MA, Nordrehaug JE, Malterud K. Hope in action—facing cardiac death: a qualitative study of patients with life-threatening disease. Int J Qual Stud Health Well-being. 2011;6(1) 10.3402/qhw.v6i1.5917.
    1. Dunn SL, Dunn LM, Rieth NP, Olamijulo GB, Swieringa LL, Holden TP, Clark JA, DeVon HA, Tintle NL. Impact of home-and hospital-based exercise in cardiac rehabilitation on hopelessness in patients with coronary heart disease. J Cardiopulm Rehabil Prev. 2017;37(1):39–48. doi: 10.1097/HCR.0000000000000205.
    1. Kornadt AE, Voss P, Rothermund K. Hope for the best, prepare for the worst? Future self-views and preparation for age-related changes. Psychol Aging. 2015;30(4):967. doi: 10.1037/pag0000048.
    1. Dunn SL. Identifying and promoting hope in patients. West J Nurs Res. 2016;38(3):267–269. doi: 10.1177/0193945915614932.
    1. Fitzgerald Miller J. Hope: a construct central to nursing. Nurs Forum. 2007;4291:12–19. doi: 10.1111/j.1744-6198.2007.00061.x.
    1. Schiavon CC, Marchetti E, Gurgel LG, Busnello FM, Reppold CT. Optimism and hope in chronic disease: a systematic review. Front Psychol. 2016;7:2022.
    1. Tutton E, Seers K, Langstaff D. An exploration of hope as a concept for nursing. J Orthop Nurs. 2009;13(3):119–127. doi: 10.1016/j.joon.2009.07.006.
    1. Kelly-Tobin, Alice Mary: Hope and Health Related Quality of Life of Older Women Who Have Had Heart Attacks. 2016; CUNY Academic Works. Url: . Accessed 14 Feb 2017.
    1. DuBois CM, Lopez OV, Beale EE, Healy BC, Boehm JK, Huffman JC. Relationships between positive psychological constructs and health outcomes in patients with cardiovascular disease: a systematic review. Int J Cardiol. 2015;195:265–280. doi: 10.1016/j.ijcard.2015.05.121.
    1. Lichtman JH, Froelicher ES, Blumenthal JA, Carney RM, Doering LV, Frasure-Smith N, Freedland KE, Jaffe AS, Leifheit-Limson EC, Sheps DS. Depression as a risk factor for poor prognosis among patients with acute coronary syndrome: systematic review and recommendations a scientific statement from the American Heart Association. Circulation. 2014;129(12):1350–1369. doi: 10.1161/CIR.0000000000000019.
    1. Mehta LS, Beckie TM, DeVon HA, Grines CL, Krumholz HM, Johnson MN, Lindley KJ, Vaccarino V, Wang TY, Watson KE. Acute myocardial infarction in women. Circulation. 2016;133(9):916–947. doi: 10.1161/CIR.0000000000000351.
    1. Tully PJ, Baumeister H, Bennetts JS, Rice GD, Baker RA. Depression screening after cardiac surgery: a six month longitudinal follow up for cardiac events, hospital readmissions, quality of life and mental health. Int J Cardiol. 2016;206:44–50. doi: 10.1016/j.ijcard.2016.01.015.
    1. Ravven SMD, Bader CBA, Azar AP, Rudolph JLMDSM. Depressive symptoms after CABG surgery: a meta-analysis. Harv Rev Psychiatry. 2013;21(2):59–69. doi: 10.1097/HRP.0b013e31828a3612.
    1. Alarcon GM, Bowling NA, Khazon S. Great expectations: a meta-analytic examination of optimism and hope. Pers Individ Dif. 2013;54(7):821–827. doi: 10.1016/j.paid.2012.12.004.
    1. Sessle BJ. The pain crisis: what it is and what can be done. Pain Res Treat. 2012;2012:6.
    1. Meissner W, Coluzzi F, Fletcher D, Huygen F, Morlion B, Neugebauer E, Pérez AM, Pergolizzi J. Improving the management of post-operative acute pain: priorities for change. Curr Med Res Opin. 2015:1–13. doi: 10.1185/03007995.2015.1092122.
    1. Choiniere M, Watt-Watson J, Victor JC, Baskett RJ, Bussieres JS, Carrier M, Cogan J, Costello J, Feindel C, Guertin MC, et al. Prevalence of and risk factors for persistent postoperative nonanginal pain after cardiac surgery: a 2-year prospective multicentre study. CMAJ. 2014;186(7):E213–E223. doi: 10.1503/cmaj.131012.
    1. Katz J, Weinrib A, Fashler SR, Katznelzon R, Shah BR, Ladak SS, Jiang J, Li Q, McMillan K, Mina DS, et al. The Toronto general hospital transitional pain service: development and implementation of a multidisciplinary program to prevent chronic postsurgical pain. J Pain Res. 2015;8:695–702. doi: 10.2147/JPR.S91924.
    1. Bjornnes AK, Parry M, Lie I, Fagerland MW, Watt-Watson J, Rustoen T, Stubhaug A, Leegaard M. Pain experiences of men and women after cardiac surgery. J Clin Nurs. 2016;25(19–20):3058–3068. doi: 10.1111/jocn.13329.
    1. Rustøen T, Wahl AK, Hanestad BR, Lerdal A, Miaskowski C, Moum T. Hope in the general Norwegian population, measured using the Herth hope index. Palliat Support Care. 2003;1(4):309–318.
    1. Hayes SN, Wood SF, Mieres JH, Campbell SM, Wenger NK. Taking a giant step toward women's heart health: finding policy solutions to unanswered research questions. Womens Health Issues. 2015;25(5):429–432. doi: 10.1016/j.whi.2015.07.001.
    1. Herth K. Abbreviated instrument to measure hope: development and psychometric evaluation. J Adv Nurs. 1992;17(10):1251–1259. doi: 10.1111/j.1365-2648.1992.tb01843.x.
    1. McGurk K and Roth PA. Quality of life, hope, social support, and self -care in heart failure patients. Thesis, University of San Diego. 2010. p. 176. ProQuest Dissertations Publishing, viewed April 17, 2017.
    1. Mahdavi A, Esmaeili R, Heidari-Gorji MA, Mohammadi-Tazeh F, Cherati JY. Anxiety and hope to life in open heart surgery patients-a cross sectional study. J Cardiovasc Dis Res. 2016;7(1):23. doi: 10.5530/jcdr.2016.1.3.
    1. Eriksson M, Asplund K, Hochwalder J, Svedlund M. Changes in hope and health-related quality of life in couples following acute myocardial infarction: a quantitative longitudinal study. Scand J Caring Sci. 2013;27(2):295–302. doi: 10.1111/j.1471-6712.2012.01032.x.
    1. Bay PS, Beckman D, Trippi J, Gunderman R, Terry C. The effect of pastoral care services on anxiety, depression, hope, religious coping, and religious problem solving styles: a randomized controlled study. J Relig Health. 2008;47(1):57–69. doi: 10.1007/s10943-007-9131-4.
    1. Van Kuiken DM. The Role of Hope in Self-care in Persons with Heart Failure. Thesis. University of Cincinnati. 2008. p. 153. ProQuest Dissertations Publishing, viewed April 17, 2017.
    1. Rustøen T, Howie J, Eidsmo I, Moum T. Hope in patients hospitalized with heart failure. Am J Crit Care. 2005;14(5):417–425.
    1. Evangelista LS, Doering LV, Dracup K, Vassilakis ME, Kobashigawa J. Hope, mood states and quality of life in female heart transplant recipients. J Heart Lung Transplant. 2003;22(6):681–686. doi: 10.1016/S1053-2498(02)00652-6.
    1. Staples P, Jeffrey J. Quality of life, hope, and uncertainty of cardiac patients and their spouses before coronary artery bypass surgery. Can J Cardiovasc Nurs. 1997;8(1):7–16.
    1. Bjornnes AK, Parry M, Lie I, Fagerland MW, Watt-Watson J, Rustoen T, Stubhaug A, Leegaard M. The impact of an educational pain management booklet intervention on postoperative pain control after cardiac surgery. Eur J Cardiovasc Nurs. 2016;16(1):18–27. doi: 10.1177/1474515116631680.
    1. Wahl AK, Rustoen T, Lerdal A, Hanestad BR, Knudsen O, Jr, Moum T. The Norwegian version of the Herth hope index (HHI-N): a psychometric study. Palliat Support Care. 2004;2(3):255–263. doi: 10.1017/S1478951504040349.
    1. Idler EL, Boulifard DA, Contrada RJ. Mending broken hearts marriage and survival following cardiac surgery. J Health Soc Behav. 2012;53(1):33–49. doi: 10.1177/0022146511432342.
    1. Holt-Lunstad J, Smith TB, Layton JB. Social relationships and mortality risk: a meta-analytic review. PLoS Med. 2010;7(7):e1000316. doi: 10.1371/journal.pmed.1000316.
    1. Sangha O, Stucki G, Liang MH, Fossel AH, Katz JN. The self-administered Comorbidity questionnaire: a new method to assess comorbidity for clinical and health services research. Arthritis Rheum. 2003;49(2):156–163. doi: 10.1002/art.10993.
    1. Merskey H, Bogduk N. International Association for the Study of Pain task force on T: classification of chronic pain : descriptions of chronic pain syndromes and definitions of pain terms. 2. Seattle: IASP Press; 1994.
    1. Cleeland CS, Ryan KM. Pain assessment: global use of the brief pain inventory. Ann Acad Med Singap. 1994;23(2):129–138.
    1. Gjeilo KH, Stenseth R, Wahba A, Lydersen S, Klepstad P. Validation of the brief pain inventory in patients six months after cardiac surgery. J Pain Symptom Manag. 2007;34(6):648–656. doi: 10.1016/j.jpainsymman.2007.01.010.
    1. StataCorp 2013. Stata statistical software: release 13. College Station, Texas: StataCorp LP.
    1. Fitzmaurice GM, Laird NM, Ware JH. Applied longitudinal analysis, 2nd ed. Chichester: Wiley; 2011.
    1. Sullivan GM, Feinn R. Using effect size—or why the P value is not enough. J Grad Med Educ. 2012;4(3):279–282. doi: 10.4300/JGME-D-12-00156.1.
    1. Utne I, Miaskowski C, Bjordal K, Paul SM, Rustoen T. The relationships between mood disturbances and pain, hope, and quality of life in hospitalized cancer patients with pain on regularly scheduled opioid analgesic. J Palliat Med. 2010;13(3):311–318. doi: 10.1089/jpm.2009.0294.
    1. Reichard RJ, Avey JB, Lopez S, Dollwet M. Having the will and finding the way: a review and meta-analysis of hope at work. J Posit Psychol. 2013;8(4):292–304. doi: 10.1080/17439760.2013.800903.
    1. Everson SA, Kaplan GA, Goldberg DE, Salonen R, Salonen JT. Hopelessness and 4-year progression of carotid atherosclerosis. Arterioscler Thromb Vasc Biol. 1997;17(8):1490–1495. doi: 10.1161/01.ATV.17.8.1490.
    1. Lamers SM, Bolier L, Westerhof GJ, Smit F, Bohlmeijer ET. The impact of emotional well-being on long-term recovery and survival in physical illness: a meta-analysis. J Behav Med. 2012;35(5):538–547. doi: 10.1007/s10865-011-9379-8.
    1. Bolier L, Haverman M, Westerhof GJ, Riper H, Smit F, Bohlmeijer E. Positive psychology interventions: a meta-analysis of randomized controlled studies. BMC Public Health. 2013;13(1):119. doi: 10.1186/1471-2458-13-119.
    1. Higginson IJ, Donaldson N. Relationship between three palliative care outcome scales. Health Qual Life Outcomes. 2004;2(1):68. doi: 10.1186/1477-7525-2-68.
    1. Feeney BC, Collins NL. A new look at social support: a theoretical perspective on thriving through relationships. Personal Soc Psychol Rev. 2015;19(2):113–147. doi: 10.1177/1088868314544222.
    1. Neuman MD. WernerRM: marital status and postoperative functional recovery. JAMA Surg. 2016;151(2):194–196. doi: 10.1001/jamasurg.2015.3240.
    1. Staniute M, Brozaitiene J, Bunevicius R. Effects of social support and stressful life events on health-related quality of life in coronary artery disease patients. J Cardiovasc Nurs. 2013;28(1):83–89. doi: 10.1097/JCN.0b013e318233e69d.
    1. Oterhals K, Hanssen TA, Haaverstad R, Nordrehaug JE, Eide GE, Norekval TM. Factors associated with poor self-reported health status after aortic valve replacement with or without concomitant bypass surgery. Eur J Cardiothorac Surg. 2015;48(2):283–292. doi: 10.1093/ejcts/ezu425.
    1. Olsman E, Leget C, Duggleby W, Willems D. A singing choir: understanding the dynamics of hope, hopelessness, and despair in palliative care patients. A longitudinal qualitative study. Palliat Support Care. 2015;13(6):1643–1650. doi: 10.1017/S147895151500019X.
    1. Kroemeke A. Dynamics of depression symptoms after myocardial infarction - the importance of changes in hope. Psychiatr Pol. 2013;47(5):799–810.
    1. Leifheit-Limson EC, Kasl SV, Lin H, Buchanan DM, Peterson PN, Spertus JA, Lichtman JH. Adherence to risk factor management instructions after acute myocardial infarction: the role of emotional support and depressive symptoms. Ann Behav Med. 2012;43(2):198–207. doi: 10.1007/s12160-011-9311-z.
    1. Ch’ng SL, Cochrane AD, Wolfe R, Reid C, Smith CI, Smith JA. Procedure-specific cardiac surgeon volume associated with patient outcome following valve surgery, but not isolated CABG surgery. Heart Lung Circ. 2015;24(6):583–589. doi: 10.1016/j.hlc.2014.11.014.
    1. Coffey S, Cairns BJ, Iung B. The modern epidemiology of heart valve disease. Heart. 2015;102(1):75–85. doi: 10.1136/heartjnl-2014-307020.
    1. De-loyde KJ, Harrison JD, Durcinoska I, Shepherd HL, Solomon MJ, Young JM. Which information source is best? Concordance between patient report, clinician report and medical records of patient co-morbidity and adjuvant therapy health information. J Eval Clin Pract. 2015;21:339–346. doi: 10.1111/jep.12327.

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