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The effects of optimism and gratitude on adherence, functioning and mental health following an acute coronary syndrome.

ABSTRACT: OBJECTIVE:This study examined the effects of optimism and gratitude on self-reported health behavior adherence, physical functioning and emotional well-being after an acute coronary syndrome (ACS). METHODS:Among 156 patients, we examined associations between optimism and gratitude measured 2 weeks post-ACS and 6-month outcomes: adherence to medical recommendations, mental and physical health-related quality of life (HRQoL), physical functioning, depressive symptoms and anxiety. Multivariable linear regression models were used, controlling for increasing levels of adjustment. RESULTS:Optimism [?=.11, standard error (S.E.)=.05, P=.038] and gratitude (?=.10, S.E.=.05, P=.027) at 2 weeks were associated with subsequent self-reported adherence to medical recommendations (diet, exercise, medication adherence, stress reduction) at 6 months in fully adjusted models. Two-week optimism and gratitude were associated with improvements in mental HRQoL (optimism: ?=.44, S.E.=.13, P=.001; gratitude: ?=.33, S.E.=.12, P=.005) and reductions in symptoms of depression (optimism: ?=-.11, S.E.=.05, P=.039; gratitude: ?=-.10, S.E.=.05, P=.028) and anxiety (optimism: ?=-.15, S.E.=.05, P=.004; gratitude: ?=-.10, S.E.=.05, P=.034) at 6 months. CONCLUSION:Optimism and gratitude at 2 weeks post-ACS were associated with higher self-reported adherence and improved emotional well-being 6 months later, independent of negative emotional states. Optimism and gratitude may help recovery from an ACS. Interventions promoting these positive constructs could help improve adherence and well-being.

SUBMITTER: Millstein RA

PROVIDER: S-EPMC6894170 | biostudies-literature | 2016 Nov - Dec

REPOSITORIES: biostudies-literature

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The effects of optimism and gratitude on adherence, functioning and mental health following an acute coronary syndrome.

Millstein Rachel A RA Celano Christopher M CM Beale Eleanor E EE Beach Scott R SR Suarez Laura L Belcher Arianna M AM Januzzi James L JL Huffman Jeff C JC

General hospital psychiatry 20160830

<h4>Objective</h4>This study examined the effects of optimism and gratitude on self-reported health behavior adherence, physical functioning and emotional well-being after an acute coronary syndrome (ACS).<h4>Methods</h4>Among 156 patients, we examined associations between optimism and gratitude measured 2 weeks post-ACS and 6-month outcomes: adherence to medical recommendations, mental and physical health-related quality of life (HRQoL), physical functioning, depressive symptoms and anxiety. Mu ...[more]

PMID: 27796252

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Project description:BackgroundPositive psychological constructs, such as optimism, are associated with beneficial health outcomes. However, no study has separately examined the effects of multiple positive psychological constructs on behavioral, biological, and clinical outcomes after an acute coronary syndrome (ACS). Accordingly, we aimed to investigate associations of baseline optimism and gratitude with subsequent physical activity, prognostic biomarkers, and cardiac rehospitalizations in post-ACS patients.Methods and resultsParticipants were enrolled during admission for ACS and underwent assessments at baseline (2 weeks post-ACS) and follow-up (6 months later). Associations between baseline positive psychological constructs and subsequent physical activity/biomarkers were analyzed using multivariable linear regression. Associations between baseline positive constructs and 6-month rehospitalizations were assessed via multivariable Cox regression. Overall, 164 participants enrolled and completed the baseline 2-week assessments. Baseline optimism was significantly associated with greater physical activity at 6 months (n=153; β=102.5; 95% confidence interval, 13.6-191.5; P=0.024), controlling for baseline activity and sociodemographic, medical, and negative psychological covariates. Baseline optimism was also associated with lower rates of cardiac readmissions at 6 months (n=164), controlling for age, sex, and medical comorbidity (hazard ratio, 0.92; 95% confidence interval, [0.86-0.98]; P=0.006). There were no significant relationships between optimism and biomarkers. Gratitude was minimally associated with post-ACS outcomes.ConclusionsPost-ACS optimism, but not gratitude, was prospectively and independently associated with superior physical activity and fewer cardiac readmissions. Whether interventions that target optimism can successfully increase optimism or improve cardiovascular outcomes in post-ACS patients is not yet known, but can be tested in future studies.Clinical trial registrationURL: http://www.clinicaltrials.gov. Unique identifier: NCT01709669.

Project description:PurposeTo assess the effect of acute coronary syndrome (ACS) patients' education on their adherence to dual antiplatelet therapy (DAPT) and on lifestyle modifications.MethodsPatients who were prescribed acetyl salicylic acid and clopidogrel DAPT within 15 days of having an ACS event were enrolled in this study. Patients were randomized into two arms: the first arm received the study intervention, which consisted of education on coronary artery disease and the importance of sustained platelet inhibition, whereas the second arm was the control group. Both arms received education on lifestyle modifications. Patients completed six visits over 1 year. At each visit, pill count was used to assess adherence to DAPT, data on lifestyle modifications were collected, and changes in weight and waist circumference were recorded. Cardiovascular risk factors were recorded at baseline and the occurrence of new events was monitored throughout the study.ResultsThere were 153 patients in Arm 1 and 168 in Arm 2. At Month 6, 99.3% of patients in Arm 1 were adherent compared with 94.4% in Arm 2 (p = 0.016). At Month 12, 303 (94.4%) patients from the overall population were adherent to DAPT and there was no significant difference between the two arms (p = 0.443). In addition, no statistically significant difference was found in mean change in weight (3 kg vs. 2 kg, p = 0.064) or mean change in waist circumference (3.5 cm vs. 2.6 cm, p = 0.071) between the two arms. There was a significant decrease in the percentage of smokers (p < 0.001) and a significant increase in the percentage of physically active patients (p < 0.001) within each arm between baseline and Month 12, but the percent change in smokers (z = 1.72, p = 0.085) and percent change in physically active patients (z = 0.76, p = 0.447) between the two arms were not significantly different. Fourteen myocardial infarctions and two strokes occurred throughout the study period.ConclusionPatient education on DAPT showed short-term effect on adherence to treatment. More effective education methods should be developed to improve long-term DAPT adherence.

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The effects of optimism and gratitude on adherence, functioning and mental health following an acute coronary syndrome.

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The effects of optimism and gratitude on adherence, functioning and mental health following an acute coronary syndrome.

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