Hopelessness In Patients Research Articles

Dog Ownership and Dog Walking: The Relationship With Exercise, Depression, and Hopelessness in Patients With Ischemic Heart Disease.

Dog ownership has been associated with increased physical activity in the general adult population. The objective of this study was to examine dog ownership and dog walking and their relationship with home-based and phase II cardiac rehabilitation exercise, depression, and hopelessness in patients with ischemic heart disease. A total of 122 patients with ischemic heart disease were included in this prospective observational study. Patients completed dog ownership/walking questions during their hospitalization. The Cardiac Rehabilitation Exercise Participation Tool, Patient Health Questionnaire-9, and State-Trait Hopelessness Scale were completed by mail at 3, 8, or 12 months later. Regression modeling was used to evaluate the significance of dog ownership/walking on exercise, depression and hopelessness. The sample was 34.4% female and had a mean age of 64.7 ± 9.1 years. Forty-two patients (34.4%) reported owning a dog. Patients who owned but did not walk their dog reported significantly lower levels of home exercise compared with patients who walked their dogs at least 1 day per week (36.8% for non-dog walkers vs 73.9% for dog walkers, P = .019). The odds of participating in home exercise were significantly higher for dog walkers compared with non-dog walkers (odds ratio, 8.1 [1.7, 38.5] vs 1.0). There were no differences in phase II cardiac rehabilitation exercise, depression, or hopelessness between dog owners and non-dog owners or between dog walkers and non-dog walkers. These findings show a beneficial effect on home-based exercise for those who dog-walk at least 1 day per week. Healthcare professionals should encourage dog walking to increase dog owners' physical activity levels.

Associated factors to anxiety and hopelessness in patients with chronic kidney disease in a public hospital in Mexico

Actualmente, la enfermedad renal crónica (ERC) es un problema de salud pública por los costos que genera al sistema de salud, y las consecuencias para pacientes y familiares. Se ha encontrado que más del 50% de los pacientes con ERC tienen algún trastorno emocional. Se realizó un estudio descriptivo transversal, con una muestra de 49 pacientes con ERC, utilizando la Escala de Hamilton para la Ansiedad y la Escala de Desesperanza de Beck. Los resultados mostraron que el 89.8% de los participantes presentaron algún grado de desesperanza, al igual que 97.9% lo hizo para ansiedad. Se encontró una asociación positiva y significativa entre los puntajes finales de las escalas de ansiedad y desesperanza (r = 0.31, p < 0.05). Es necesario instrumentar estrategias de intervención tendientes a generar un mejor apoyo psicológico a la situación emocional de los pacientes con esta enfermedad.

Abstract P312: High State and Trait Hopelessness Levels Predict Lower Home-based Exercise Participation in Patients With Coronary Heart Disease

Introduction: Hopelessness is associated with increased adverse events and decreased survival in patients with coronary heart disease (CHD). Hopelessness can persist in these patients and reduce their participation in hospital-based cardiac rehabilitation (CR) exercise following an acute event. Because the majority of CHD patients do not attend a hospital-based CR exercise program, examination of factors affecting home exercise is needed. The purpose of this study was to describe the impact of hopelessness levels on both home- and hospital based CR exercise participation in patients with CHD. Hypothesis: It was hypothesized that higher state and trait hopelessness levels would adversely affect both home- and hospital-based CR exercise participation. Methods: The Theory of Hopelessness Depression was used as a foundation for study aims. Using a descriptive, longitudinal design, 282 patients who had been hospitalized with a CHD event were asked to complete the State-Trait Hopelessness Scale (STHS) during their hospitalization and the STHS and the Cardiac Rehabilitation Exercise Participation Questionnaire at 3, 8, and 12 months after hospital discharge. Patients who provided data at any two concurrent time points over the year were included in the analyses. Regular exercise was defined as walking or biking ≥3 days/week in a home- or hospital-based Phase II CR exercise program. Logistic regression was used to evaluate the relationship between STHS scores on the likelihood that patients would participate in regular exercise in home- or hospital-based Phase II CR settings. Results: Patients were predominantly male (64.9%) with a mean age of 65.4±9.7 years. Patients had persistent, modest levels of state and trait hopelessness across all time points. High levels of state and trait hopelessness were predictive of lower home-based exercise participation (state: OR 0.4, 95% CI [0.1, 0.7], p=0.002; trait: OR 0.4, 95% CI [0.2, 0.8], p=0.01) but not hospital-based Phase II CR exercise, after adjusting for age and sex. Conclusions: These findings demonstrate the importance of assessing hopelessness in patients with CHD and provide critical evidence of the need for clinicians to encourage CHD patients who are feeling hopeless to participate in CR exercise, particularly in the home setting.

Depression, anxiety, hopelessness and quality of life in users of cocaine/crack in outpatient treatment.

To identify symptoms of anxiety, depression, and feelings of hopelessness in patients in outpatient treatment for substance dependency and to test for correlations with various aspects of their quality of life. A cross-sectional study of a sample of 25 men in recuperation from substance dependency, selected by convenience. We assessed symptoms of depression (Beck Depression Inventory-II), anxiety (Beck Anxiety Inventory), hopelessness (Beck Hopelessness Scale), and quality of life (World Health Organization Quality of Life instrument-Abbreviated version [WHOQOL-Bref]), and also analyzed sociodemographic profile, substance abuse, and family history. Categorical variables were expressed as frequencies and percentages and quantitative variables as means and standard deviations or as medians and interquartile ranges. We also analyzed Spearman correlations to a 5% significance level. The study revealed prevalence rates of 32% for depression, 24% for anxiety, and 12% for hopelessness, at a moderate/severe level. Correlations between Beck scales and WHOQOL-Bref were significant; but impacts differed in the four areas evaluated. Overall, we observe global negative impacts on subjects' lives, affecting their psychiatric symptoms and quality of life and their relationships and occupational factors to a similar degree. The results show that the lower the scores on these scales, the better the quality of life in some areas, indicating that there is a negative correlation between psychiatric symptoms and quality of life.

Depression, Hopelessness and Social Support among Breast Cancer Patients: in Highly Endogamous Population

Aim:The aim of this study was to assess the relationship between different demographic variables, hopelessness, depression and social support of Breast cancer patients in Qatari’s population.Design:This is an observational cohort hospital based study.Subjects and Methods:The study included 678 breast cancer patients. The questionnaires included a demographic questionnaire, the Beck Hopelessness Scale (BHS), Back Depression Scale (BDS) and Multidimensional Scale of Perceived Social Support (MSPSS). The demographic questionnaire was used to assess patients’ basic information including gender, age, marital status, education, family size, and place of residence. Medical information regarding cancer stage, the time passed since diagnosis, treatment, and duration of disease were recorded.Results:The mean age of the studied women was 47.7±10.2 years. Among the studied patients, 34.7% were Qataris and 65.3% were Arab expatriates. Nearly 39.2% of the patients were in pre-menopausal status and 60.8% in post-menopausal status. 86.1% of women were married. 14.6% were illiterate women, 20.9% were university graduates and 37.2% were housewives. Smoking habit was less common in studied Arab women (9.1%), but, sheesha smoking was more common, 17.7%. Daily physical activity indicated 25.7% were walking 30 minutes per-day and 14% were walking 60 minutes per day. 30.4% of them had consanguineous parents. Breast feeding was practiced among 67.7% of women and over 73% were considered overweight and obese. Furthermore, over 75% of breast cancer women were at the Stage 3 (40.9%) and Stage 4 (35.8%) of cancer. The percentage of patients who underwent mastectomy and lumpectomy were 49.3 % and 50.7%, respectively. It was observed that 27.7% of BDI patients had moderate depression and 19.5% of the BDI patients had severe depression and with mean and standard deviation 25.1±7.7. Also, the mean and SD of BDI for consanguineous has showed statistically significant 28.4±5.7 than non- consanguineous 23.2± 8.0 (p<0.001). All socio-demographic variables showed statistically significant differences with the total BHS score. The highest score belongs to the family sub-dimension.Conclusion:The present study indicates that hopelessness of the patients with breast cancer decreased with the increase in their social support. Therefore, activating patient social support systems is of importance in increasing their levels of hope. The present study revealed the coexistence of the socio-demographic, physical, psychological, and cognitive problems faced by patients with cancer.

Impact of Home- and Hospital-Based Exercise in Cardiac Rehabilitation on Hopelessness in Patients With Coronary Heart Disease.

Hopelessness is associated with increased adverse events and decreased survival in patients with coronary heart disease (CHD). The purpose of this research was to examine the effect of regular home- and hospital-based cardiac rehabilitation (CR) exercise on hopelessness levels in patients with CHD, hypothesizing that increased exercise in either setting would lead to decreased state hopelessness. A descriptive longitudinal design was used at a large teaching hospital in Michigan. A total of 324 patients provided data during hospitalization and at least 1 followup time point (3, 8, and 12 months). The patients had persistent, modest levels of state and trait hopelessness across all time points. Among home exercisers with moderate to severe state hopelessness at baseline, both mean state (P = .002) and trait (P = .02) hopelessness were reduced at later time points compared with those who quit or did not start exercise. Multivariable models showed that when individuals had moderate to severe baseline state hopelessness, home exercise remained associated with decreases in state hopelessness compared with no exercise, even after adjusting for hospital exercise, depression, and demographic variables. Exercise may be effective in reducing moderate to severe hopelessness in patients with CHD. Moderate to severe baseline state hopelessness was a predictor of attrition in this cohort, especially for home exercisers, but this was mediated in hospital-based programs. Further research is needed to determine how hopeless individuals can be encouraged to exercise and whether home- or a hospital-based CR exercise is superior in impacting hopelessness.

Biopsychosocial correlates of hope in Asian patients with cancer: a systematic review.

ObjectiveTo examine the factors associated with hope and hopelessness in patients with cancer in Asian countries, and the instruments used to measure hope and hopelessness.MethordsA comprehensive systematic review was conducted with search terms, including cancer, hope, hopelessness and individual Asian country names, on CINAHL, Embase, PsycINFO, PubMed and Scopus databases. Only quantitative studies on adult cancer populations in Asia examining hope or hopelessness were included.ResultsA total of 2062 unique articles were retrieved from the databases, and 32 studies were selected for inclusion in this review. Hope and hopelessness were most frequently measured with the Herth Hope Index and the Mental Adjustment to Cancer Scale, respectively. The biopsychosocial factors that were most consistently associated with hope and hopelessness included sociodemographic variables (education, employment and economic status); clinical factors (cancer stage, physical condition and symptoms); and psychosocial factors (emotional distress, social support and connections, quality of life, control or self-efficacy, as well as adjustment and resilience).DiscussionThere is a need for more studies from South and Southeast Asia as most studies hailed from East Asia. This review highlighted the possibility of cultural differences influencing factors related to hope, suggesting that cross-cultural studies specifically would facilitate understanding behind these variations, although future reviews on hope should also include studies on hopelessness for a comprehensive understanding of the concept. Finally, more longitudinal research could be conducted to assess whether the factors associated with hope and hopelessness change over time and disease progression.

The relationship between healthy life style behaviors and hopelessness in patients with heart failure

The relationship between healthy life style behaviors and hopelessness in patients with heart failure

Depression, Anxiety, and Hopelessness in Patients with Chikungunya Fever in Brazil

Chikungunya virus (CHIKV) is an alphavirus found worldwide that is now, with a very large outbreak mostly in the northeast of the country, an emerging disease in Brazil. This study consisted of a series of 18 females and two male patients, with ages ranging from 31 to 87 years and a mean age of 54. The patients presented anxiety or depressive symptoms that emerged during the acute phase of CHIKV infection and remained for at least one year. For the purpose of statistical comparisons, a control group was formed of 15 females and five male individuals without CHIKV infection and aged from 29 to 72 and a mean age of 48. Anxiety, depression, and hopelessness symptoms were prevalent in patients one year after CHIKV infection.

Dimensionality, Stability, and Validity of the Beck Hopelessness Scale in Cancer Patients Receiving Curative and Palliative Treatment

ContextHopelessness is a clinically important construct in patients with advanced illness. ObjectivesTo evaluate the dimensionality, stability, and validity of the Beck Hopelessness Scale (BHS) in cancer patients receiving either curative or palliative treatment. MethodsFollowing a longitudinal design, we assessed a sample of cancer patients receiving either curative or palliative treatment (N = 315) at baseline and at follow-up after 12 months (N = 158). In addition to hopelessness, we measured depression (Patient Health Questionnaire–9), anxiety (General Anxiety Disorder–7), and health-related quality of life (Short-Form Health Survey–8). We analyzed dimensionality, stability, and construct validity of the BHS using confirmatory factor analysis, exploratory factor analysis and correlational analysis. ResultsIndependent of treatment intention, confirmatory factor analyses resulted in unsatisfactory model fits. Exploratory factor analysis yielded a two-factor solution in both groups receiving curative or palliative treatment. Factor 1 reflected pessimistic/resigned beliefs (Cronbach alpha ≥ 0.85), Factor 2 reflected positive beliefs toward the future (Cronbach alpha = 0.73). Both subscales showed significant associations with anxiety, depression, and decreased health-related quality of life. The factorial structure was partially replicated in patients being reexamined after 12 months (CMIN/DF = 2.130, Standardized Root Mean Square Residual = 0.0716, Comparative Fit Index = 0.904, Tucker-Lewis-Index = 0.883, Root Mean Square Error of Approximation = 0.085). Hopelessness scores were significantly higher in patients reporting suicidal ideation according to the Patient Health Questionnaire–9. ConclusionOur study demonstrates psychometric limitations of the BHS in patients receiving both curative and palliative treatment, suggesting reduced utility in cancer populations. Given the clinical importance of the construct, a cancer-specific approach to capture the unique meaning of hopelessness in patients with severe medical illness is recommended.

Depression and hopelessness in patients with acute leukemia: the psychological impact of an acute and life-threatening disorder.

Acute leukemia (AL) is a life-threatening cancer associated with substantial morbidity and mortality, particularly in older adults. Given that there has been little research on the psychological impact of such malignancies with acute onset, we assessed the prevalence and correlates of depression and hopelessness in patients with AL. Three hundred forty-one participants were recruited within 1month of diagnosis or relapse and completed the Beck Depression Inventory-II (BDI-II), Beck Hopelessness Scale (BHS), Memorial Symptom Assessment Scale, and other psychosocial measures. Multivariate regression analyses identified correlates of depression and hopelessness. 17.8% reported clinically significant depressive symptoms (BDI-II ≥ 15), 40.4% of which were in the moderate-severe range (BDI-II ≥ 20). 8.5% reported significant symptoms of hopelessness (BHS ≥ 8). Depression was associated with greater physical symptom burden (adjusted R(2) = 48.4%), while hopelessness was associated with older age and lower self-esteem (adjusted R(2) = 45.4%). Both were associated with poorer spiritual well-being. Clinically significant depressive symptoms were common early in the course of AL and related to physical symptom burden. Hopelessness was less common and associated with older age and lower self-esteem. The results suggest that whereas depression in AL may be related to disease burden, the preservation of hope may be linked to individual resilience, life stage, and realistic prognosis.Copyright © 2015 John Wiley & Sons, Ltd.

Effects of Depression, Self-esteem, and Family Support Towards Hopelessness of Patients Taking Hemodialysis

The study is to examine the effects of depression, self-esteem and family support to hopelessness of patients taking hemodialysis. The Subjects were 147 patients who were taking hemodialysis three times a week in a hospital and clinic which is located in B city in Gyonggi-do. Data collection was performed from the 1st to 10th in September, 2014. Subjects’ average age was 52.4, male patients were 54.%, high school graduates were 48.3%, 57.1% had a religion, 85.7% had no jobs, 74.1% were economically difficult, most of them were taking hemodialysis three times a week. From the study, having a religion(β= .109), depression(β= .338), self-esteem(β= -.567), family support(β= -.137) were shown to affect the degree of hopelessness significantly, and adj R2 were 57.5. Findings suggest that intervention aiming at decrease of depression, nurturing of self-esteem, and improvement of family support are expected to lead to the decrease of hopelessness of patients taking hemodialysis. Received (May 15, 2015), Review Request(May 18, 2015), Review Result(June 03, 2015) Accepted(June 24, 2015), Published(August 31, 2015) 139-742 Sahmyook Univ. Graduate School, Wharangro 815, Nowon-gu, Seoul, Korea email: chldls2012@nate.com (Corresponding Author) 139-742 Dept. of Nursing, Sahmyook Univ., Wharangro 815, Nowon-gu, Seoul, Korea email: hansj@syu.ac.kr Effects of Depression, Self-esteem, and Family Support Towards Hopelessness of Patients Taking Hemodialysis Copyright c 2015 HSST 218

Aleksitimik olan ve olmayan major depresif bozukluk hastalarında intihar girişimi, intihar düşüncesi ve umutsuzluk düzeyleri

Suicide attempt, suicidal ideation and hopelessness levels in major depressive patients with and without alexithymia Objective: It is known that hopelessness and alexithymia levels are increased in patients with depressive disorder. In the literature, reports are suggesting that high levels of hopelessness in patients with depressive disorder increase suicide attempts and ideations. Here we aimed to investigate whether there are any differences in terms of suicidal ideation, suicide attempt and hopelessness levels in major depressive disorder patients with and without alexithymia. Method: In this study, 99 patients diagnosed with major depressive disorder according to structured interview for DSM-IV (SCID-I/CV) and 50 healthy subjects were included. Sociodemographic questionnaire, Toronto Alexithymia Scale (TAS-20), Beck Hopelessness Scale (BHS), Scale for Suicidal Ideation (SSI) and Hamilton Rating Scale for Depression (HRSD) were administered to patients and controls. Additionally, Suicide Intent Scale (SIS) was administered to patients with suicide attempt. Results: There was no significant difference in terms of sociodemographic data (except for the marital status) between major depressive patients with or without alexithymia and healthy controls. According to a cut off point of 61 for TAS-20, 34.3% (n=34) of the patient group was alexithymic and 65.7% (n=65) was non-alexithymic. Rate of suicide attempt was higher in the alexithymic major depressive patients (67.6%) than the non-alexithymic major depressive patients (29.2%). Mean scores of SSI and BHS were higher in alexithymic patients than non-alexithymic patients. There was a positive correlation between TAS-1 (difficulty identifying feelings), TAS-2 (difficulty expressing feelings) and BHS, SSI scores. Conclusion: In our study, suicidal ideation, suicide attempt and hopelessness levels were higher in major depression patients with alexithymia. Higher incidence of suicide attempts in major depressive patients with higher alexithymia levels and higher suicidal ideation and hopelessness levels in this group of patients suggest the possibility of alexithymia being a predictive factor for suicide attempt.

Hopelessness and Complementary Therapy Use in Patients With Ovarian Cancer

Hopelessness negatively affects ovarian cancer patients' quality of life (QOL). Research validating the effects of complementary and alternative medicine (CAM) use on QOL and hope is scarce, even though QOL and hope are reasons that patients cite for using CAM therapy. Clinicians need effective, evidence-based interventions to improve QOL and reduce hopelessness. The objectives of this study were to examine factors influencing hopelessness in patients with newly diagnosed disease, long-term survivors, and patients experiencing ovarian cancer recurrence and to examine the effects of CAM on hopelessness in the same population. Surveys of ovarian cancer patients (N = 219) undergoing treatment at a comprehensive cancer center in the United States were analyzed. Descriptive, correlation, and multivariate analyses described variables and demonstrated the effects of sociodemographics, disease state, psychological distress, QOL, CAM use, and faith on hopelessness. Patients ages 65 years or older (-0.95, P = .03), with strong faith (-0.28, P = .00), and good QOL (0.11, P = .00) directly reduced hopelessness scores (mean, 3.37). Massage therapy substantially reduced hopelessness scores (-1.07, P = .02); holding age constant, employed patients were twice as likely to use massage (odds ratio, 2.09; P = .04). Patients who had newly diagnosed and recurrent ovarian cancer were more hopeless because of greater distress from symptoms and adverse effects of treatment. Patients who used massage therapy were significantly less hopeless, as were those with strong faith and well-controlled disease symptoms and treatment for adverse effects. Support of spiritual needs and symptom management are important interventions to prevent and/or reduce hopelessness, especially for patients with newly diagnosed and recurrent ovarian cancer. Further research testing the positive effect of massage interventions on hopelessness is needed.

Social Support and Hopelessness in Patients with Breast Cancer

Patients with breast cancer can experience a feeling of hopelessness very deeply in the adjustment process, and the social support provided during this period can be effective in increasing the level of hope. The present study aimed to identify breast cancer patients' social support and hopelessness level. The target population of this analytical study was all breast cancer patients (total of 85) who had treatment in the oncology department of a university hospital located in Adana/Turkey and who met the inclusion criteria. Data were collected through "Personal Information Form", "Beck Hopelessness Scale (BHS) " and "Multidimensional Scale of Perceived Social Support" (MSPSS). Analysis was performed using Shapiro Wilk, One Way ANOVA Welch, Student t-test, Mann Whitney U, and Kruskall Wallis tests. Homogeneity of variance was tested with the Levene, Bonferroni and Games Howell tests. Mean scores and standard deviation values are given as descriptive statistics. Average age of the participants with breast cancer is 48.6 ∓ 10.6. Of all the participants, 84.7% are married, 49.4% graduated from primary school, 81.2% are housewives, and 82.4% had children. The participants' multidimensional perceived social support total scores were found to be high (57.41 ∓ 13.97) and hopelessness scale scores low (5.49 ∓ 3.80). There was a reverse, linear relationship between hopelessness scale scores and social support total scores (r=-0.259, p=0.017). A statistically significant relationship was found between hopelessness scores and education level and having children, occupation, income status, and education level of spouses (p<0.05). The present study indicates that hopelessness of the patients with breast cancer decreased with the increase in their social support. Therefore, activating patient social support systems is of importance in increasing their level of hope.

ARE HOPELESSNESS, DEMOGRAPHIC AND CLINICAL CHARACTERISTICS OF SUICIDAL ATTEMPTS BEING A CUE OF A NEW ATTEMPT?

Bacground: This study aimed the relationship between some demographic and clinical characteristics of suicide attempt with hopelessness, distressing life events prior to the attempt in individuals who attempted suicide and compares the outcomes with healthy volunteers with respect to several sociodemographic variables. Methods: We applied the Clinical Interview for DSM-IV Axis I Disorders (SCID-I), the Beck Depression Inventory (BDI), the Beck Anxiety Scale (BAS), Beck Hopelessness Scale (BHS), the Scale for Suicide Ideation, the Suicidal Behavior Scale, the Life Events List in 50 patients who attempted suicide and 52 healthy volunteers. Results: Twenty seven patients (54%) had a suicide plan before the attempt, and 32 patients (64%) shared this plan with their immediate environment. Of these patients, 22 (44%) reported that they still had suicidal thought, and 23 (46%) reported that the stressor life event still continued. The scores of Hopelessness Scale and its subscales were significantly higher in the suicide group both with and without depression compared to the control group. Conclusion: It was concluded to be important to follow up suicidal thoughts, negative life events and hopelessness in patients who attempted suicide or at a risk of suicide attempt.

Temperaments mediate suicide risk and psychopathology among patients with bipolar disorders

BackgroundSeveral studies have demonstrated that bipolar II (BD-II) disorder represents a quite common, distinct form of major mood disorders that should be separated from bipolar I (BD-I) disorder. The aims of this cross-sectional study were to assess temperament and clinical differences between patients with BD-I and BD-II disorders and to assess whether temperament traits are good predictors of hopelessness in patients with bipolar disorder, a variable highly associated with suicidal behavior and ideation. MethodParticipants were 216 consecutive inpatients (97 men and 119 women) with a Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR), BD who were admitted to the Sant'Andrea Hospital's psychiatric ward in Rome (Italy). Patients completed the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego—Autoquestionnaire, the Beck Hopelessness Scale (BHS), the Mini International Neuropsychiatric Interview (MINI), and the Gotland Scale of Male Depression. ResultsPatients with BD-II had higher scores on the BHS (9.78 ± 5.37 vs 6.87 ± 4.69; t143.59 = −3.94; P < .001) than patients with BD-I. Hopelessness was associated with the individual pattern of temperament traits (ie, the relative balance of hyperthymic vs cyclothymic-irritable-anxious-dysthmic). Furthermore, patients with higher hopelessness (compared with those with lower levels of hopelessness) reported more frequently moderate to severe depression (87.1% vs 38.9%; P < .001) and higher MINI suicidal risk. ConclusionTemperaments are important predictors both of suicide risk and psychopathology and may be used in clinical practice for better delivery of appropriate care to patients with bipolar disorders.

Religious and Spiritual Practices Among Patients with Cancer

The aim of this study was to investigate the frequency with which cancer patients engage in religious and spiritual practices, the methods used, the reasons for such a search, and the levels of depression and hopelessness in patients who seek spiritual assistance. One hundred and ten radiation oncology patients, who gave voluntary informed consent were included in this study. Questionnaires about religious and spiritual practices were administered, along with the Beck Depression and Beck Hopelessness scales. Twenty percent of the patients preferred spiritual practices. Female gender, lower education levels, and higher depression and hopelessness scores were associated with this preference. The frequency of depression was 18.2%, and the frequency of hopelessness was 20.9%. A significant number of cancer patients engaged in religious and spiritual practices. We recommend that practitioners offer their patients brief but sufficient information about religious and spiritual support and determine their patients' depression and hopelessness levels.

Salivary dehydroepiandrosterone (DHEA) levels in patients with the complaint of burning mouth: a case-control study

This study was conducted to evaluate salivary dehydroepiandrosterone (DHEA) levels, salivary flow rate (SFR), depression, and hopelessness in patients with the complaint of burning mouth (BM). Thirty female patients with BM and 30 age-matched control women without any complaint of burning mouth were enrolled. After anamnesis and oral examination, the salivary flow rate was determined. Depression and hopelessness were evaluated by the application of inventories. Two saliva samples were collected for DHEA analysis. Dysgeusia (P = .045) and xerostomia (P = .003) were significantly higher in the BM group. The BM patients showed significantly lower salivary flow rate, both under stimulation (P = .001) and at rest (P < .001). Significant differences between the groups were not found in the depression (P = .416) or hopelessness (P = .597) scores. The BM group revealed significantly lower salivary DHEA levels in the morning samples (P = .003). Patients with BM exhibit decreased morning salivary DHEA as well as dysgeusia and hyposalivation more frequently than control subjects. Additional investigations are needed to clarify this association.

Hopelessness and Its Effect on Cardiac Rehabilitation Exercise Participation Following Hospitalization for Acute Coronary Syndrome

Hopelessness has been associated with a higher risk of fatal and nonfatal coronary heart disease, yet very few studies have examined hopelessness after a cardiac event. This investigation examined hopelessness as an independent predictor of participation in a hospital-based cardiac rehabilitation exercise program. A total of 207 patients with acute coronary syndrome were interviewed at 3 and 8 months after hospital discharge. Measures included 1 factor of the Beck Hopelessness Scale, the Center for Epidemiological Studies Depression Scale, the Activity Status Index, the Charlson Comorbidity Index, a sociodemographic variables tool, and a cardiac rehabilitation exercise participation questionnaire. Random-effects logistic regression analysis revealed that hopelessness persisted over time and was an independent predictor of lower exercise participation. In contrast, depression showed no significant influence on exercise participation. Study findings suggest the importance of assessing hopelessness in patients with acute coronary syndrome and identifying approaches to exercise recommendations that directly address hopelessness. Interventions focused on the prevention and treatment of hopelessness symptoms may contribute to improved recovery of patient with acute coronary syndrome.