Stress, cognitive appraisal, coping, and event free survival in patients with heart failure.
Abdullah S Alhurani, Rebecca Dekker, Muayyad Ahmad and 7 others
PMID 29627073WHAT IT FOUND
After accounting for age, gender, and heart failure class, stress, appraisal, and coping were not shown to predict cardiac rehospitalization or death within 6 months.
Of 88 heart failure patients, 29 had this outcome.
Key findings
01After accounting for age, gender, and NYHA class, neither cognitive appraisal types nor coping styles significantly predicted event-free survival.
02Of 88 patients followed for 6 months, 29 had cardiac rehospitalization or death: 7 died and 22 were hospitalized for cardiac reasons.
03Higher stress was associated with more harm/loss appraisal and more avoidant emotional coping.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was observational, so it cannot show that stress, appraisal, or coping caused rehospitalization or death. The sample was a convenience sample and was smaller than the study's own power analysis recommended. The 6-month follow-up may have been too short to detect effects on survival. Anxiety and depression were not included as variables, although the authors note they may affect survival. Brief scales may not have fully captured stress, appraisal, or coping. The sample was drawn from Kentucky, and cultural context may have influenced findings.
Declared interests
The supplied metadata lists NIH extramural research support. The article text does not include a conflict-of-interest declaration.
The easy way to misread this
Do not conclude that reducing stress or changing appraisal and coping will improve heart failure survival. The adjusted survival analysis found no significant predictors, and the study was observational with a sample smaller than its own power analysis recommended.