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Investigating Rurality as a Risk Factor for State and Trait Hopelessness in Hospitalized Patients With Ischemic Heart Disease
BACKGROUND: Rurality and hopelessness are each associated with increased mortality in adults with ischemic heart disease (IHD), yet there is no known research examining rurality as a risk factor for hopelessness in patients with IHD. This study evaluated rurality as a risk factor for state and trait...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8649252/ https://www.ncbi.nlm.nih.gov/pubmed/34465185 http://dx.doi.org/10.1161/JAHA.121.020768 |
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author | Bomgaars, Deb Jensen, Gwenneth A. White, Lynn L. Van De Griend, Kristin M. Visser, Angela K. Goodyke, Madison P. Luong, Anna Tintle, Nathan L. Dunn, Susan L. |
author_facet | Bomgaars, Deb Jensen, Gwenneth A. White, Lynn L. Van De Griend, Kristin M. Visser, Angela K. Goodyke, Madison P. Luong, Anna Tintle, Nathan L. Dunn, Susan L. |
author_sort | Bomgaars, Deb |
collection | PubMed |
description | BACKGROUND: Rurality and hopelessness are each associated with increased mortality in adults with ischemic heart disease (IHD), yet there is no known research examining rurality as a risk factor for hopelessness in patients with IHD. This study evaluated rurality as a risk factor for state and trait hopelessness in adults hospitalized with IHD in samples drawn from the Great Lakes and Great Plains regions of the United States. METHODS AND RESULTS: A descriptive cross‐sectional design was used. Data were collected from 628 patients hospitalized for IHD in the Great Lakes (n=516) and Great Plains (n=112). Rural–Urban Commuting Area codes were used to stratify study participants by level of rurality. Levels of state hopelessness (measured by the State‐Trait Hopelessness Scale) were higher in rural patients (58.8% versus 48.8%; odds ratio [OR], 1.50; 95% CI, 1.03–2.18), a difference that remained statistically significant after adjusting for demographics, depression severity (measured by the Patient Health Questionnaire–8), and physical functioning (measured by the Duke Activity Status Index; OR, 1.59; 95% CI, 1.06–2.40; P=0.026). There was evidence of an interaction between marital status and rurality on state hopelessness after accounting for covariates (P=0.02). Nonmarried individuals had an increased prevalence of state hopelessness (nonmarried 72.0% versus married 52.0%) in rural areas (P=0.03). CONCLUSIONS: Rural patients with IHD, particularly those who are nonmarried, may be at higher risk for state hopelessness compared with patients with IHD living in urban settings. Understanding rurality differences is important in identifying subgroups most at risk for hopelessness. REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT04498975. |
format | Online Article Text |
id | pubmed-8649252 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-86492522022-01-14 Investigating Rurality as a Risk Factor for State and Trait Hopelessness in Hospitalized Patients With Ischemic Heart Disease Bomgaars, Deb Jensen, Gwenneth A. White, Lynn L. Van De Griend, Kristin M. Visser, Angela K. Goodyke, Madison P. Luong, Anna Tintle, Nathan L. Dunn, Susan L. J Am Heart Assoc Original Research BACKGROUND: Rurality and hopelessness are each associated with increased mortality in adults with ischemic heart disease (IHD), yet there is no known research examining rurality as a risk factor for hopelessness in patients with IHD. This study evaluated rurality as a risk factor for state and trait hopelessness in adults hospitalized with IHD in samples drawn from the Great Lakes and Great Plains regions of the United States. METHODS AND RESULTS: A descriptive cross‐sectional design was used. Data were collected from 628 patients hospitalized for IHD in the Great Lakes (n=516) and Great Plains (n=112). Rural–Urban Commuting Area codes were used to stratify study participants by level of rurality. Levels of state hopelessness (measured by the State‐Trait Hopelessness Scale) were higher in rural patients (58.8% versus 48.8%; odds ratio [OR], 1.50; 95% CI, 1.03–2.18), a difference that remained statistically significant after adjusting for demographics, depression severity (measured by the Patient Health Questionnaire–8), and physical functioning (measured by the Duke Activity Status Index; OR, 1.59; 95% CI, 1.06–2.40; P=0.026). There was evidence of an interaction between marital status and rurality on state hopelessness after accounting for covariates (P=0.02). Nonmarried individuals had an increased prevalence of state hopelessness (nonmarried 72.0% versus married 52.0%) in rural areas (P=0.03). CONCLUSIONS: Rural patients with IHD, particularly those who are nonmarried, may be at higher risk for state hopelessness compared with patients with IHD living in urban settings. Understanding rurality differences is important in identifying subgroups most at risk for hopelessness. REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT04498975. John Wiley and Sons Inc. 2021-09-01 /pmc/articles/PMC8649252/ /pubmed/34465185 http://dx.doi.org/10.1161/JAHA.121.020768 Text en © 2021 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
spellingShingle | Original Research Bomgaars, Deb Jensen, Gwenneth A. White, Lynn L. Van De Griend, Kristin M. Visser, Angela K. Goodyke, Madison P. Luong, Anna Tintle, Nathan L. Dunn, Susan L. Investigating Rurality as a Risk Factor for State and Trait Hopelessness in Hospitalized Patients With Ischemic Heart Disease |
title | Investigating Rurality as a Risk Factor for State and Trait Hopelessness in Hospitalized Patients With Ischemic Heart Disease |
title_full | Investigating Rurality as a Risk Factor for State and Trait Hopelessness in Hospitalized Patients With Ischemic Heart Disease |
title_fullStr | Investigating Rurality as a Risk Factor for State and Trait Hopelessness in Hospitalized Patients With Ischemic Heart Disease |
title_full_unstemmed | Investigating Rurality as a Risk Factor for State and Trait Hopelessness in Hospitalized Patients With Ischemic Heart Disease |
title_short | Investigating Rurality as a Risk Factor for State and Trait Hopelessness in Hospitalized Patients With Ischemic Heart Disease |
title_sort | investigating rurality as a risk factor for state and trait hopelessness in hospitalized patients with ischemic heart disease |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8649252/ https://www.ncbi.nlm.nih.gov/pubmed/34465185 http://dx.doi.org/10.1161/JAHA.121.020768 |
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