and Medicine for Seniors
Senior Heart Patients Feeling Hopeless Find Relief
with Home Exercise
Patients likely thinking more
positively about the future, more capable of making positive changes for
a healthy lifestyle
2014 — Home exercise can ease feelings of hopelessness in older people –
average age of 66 - with
disease, according to a study presented at the American Heart
Association’s Scientific Sessions 2014.
Feeling hopeless can be dangerous
because it can discourage people from taking healthful steps such as
exercising or quitting smoking, said Susan L. Dunn, Ph.D., R.N., lead
author of the study and a professor of nursing at Hope College in
People with hopelessness may also
suffer from depression, which is marked by a loss of interest in
activities they normally enjoy.
“For the first time, we show the
beneficial effect of exercise in helping patients to feel more hopeful.
With home exercise, patients are likely thinking more positively about
the future and feeling more capable of making positive changes for a
healthy lifestyle,” Dunn said.
Past studies have linked the
feeling of hopelessness to the development and worsening of coronary
heart disease and a higher risk of complications and death. Yet, little
research has been done on helping these patients and many healthcare
professionals overlook things like mental state, attitude, perspective
and outlook as aspects of patient care.
The small new study involved 324
patients (average age 66, 33 percent women and 93 percent white) with
coronary heart disease.
Researchers developed an instrument
to measure feelings of hopelessness: “state” hopelessness, which is how
pessimistic and helpless patients feel currently, and “trait”
hopelessness, which captures how patients typically feel over much
At the study’s outset, while still
in the hospital, 24 percent of the patients had current feelings of
hopelessness, 28 percent expressed long-term feelings of hopelessness
and 30 percent had both types, at moderate to severe levels.
During a year, those who walked or
biked at home at least three days a week had a 12 percent reduction in
state hopelessness scores — even when considering other relevant
circumstances such as age, participation in hospital-based exercise and
factors of depression. This reduction was statistically significant and
so was not due to chance.
The researchers were surprised to
find that hospital-based cardiac rehabilitation exercise didn’t impact
current hopelessness. Perhaps the initiative required to exercise at
home increased patients’ sense of empowerment about their health, Dunn
“Individuals with trait
hopelessness feel chronically helpless about many areas of their life,”
Dunn said, suggesting that longer-term hopelessness may be harder to
A key limitation of the small study
was that some patients who felt the most hopeless dropped out over time.
Also, further research is needed to examine hopelessness and exercise in
racially diverse groups.
Healthcare providers need to assess
the presence and severity of hopelessness in patients before hospital
discharge, Dunn said.
“All patients should be encouraged
to participate in a regular exercise program,” she said. “Special
encouragement is needed for patients who are moderately to severely
hopeless, as they may be the most vulnerable and the least likely to
exercise, yet benefit the most.”
Co-authors are Maureen Dunn, Ph.D.;
Nicole Rieth, B.S.N., R.N.; Jacob Clark, B.S.; and Nathan Tintle, Ph.D.
Author disclosures are on the manuscript.
The Howard Hughes Medical
Institute, Great Lakes Colleges Association and Kappa Epsilon
Chapter-at-Large of Sigma Theta Tau Honor Society of Nursing funded the