Associations Among Perceived Social Support, Physical Activity, and Health-Related Quality of Life in Patients With Ischemic Heart Disease Reporting Moderate to Severe Hopelessness

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BACKGROUND: Associations among perceived social support (PSS), physical activity (PA), and health-related quality of life (HRQoL) in individuals with ischemic heart disease (IHD) are well established. However, little is known about these associationsin patients with IHD experiencing hopelessness. OBJECTIVE: The objective of this study is to explore the associations among PSS, PA, and HRQoL in patients with IHD reporting moderate to severe hopelessness. METHODS: Using a cross-sectional design, secondary data were collected from 156 participants enrolled in a randomized controlled trial while hospitalized in the Midwestern United States. Data were collected 2 weeks after hospital discharge, including the Cardiac Rehabilitation Exercise Participation Tool, ENRICHD Social Support Inventory, EuroQol 5-Dimension 5-Level, and a demographic form. Linear models were used to assess associations among the variables, and Macro process mediation was completed to explore potential mediation. RESULTS: Most participants were male, had some college education or higher, and non-Hispanic White. Over half of the sample were married and not employed (eg, disabled, retired). Higher PSS and higher PA were each separately associated with higher HRQoL after adjusting for relevant covariates (PSS: rpartial = -0.24, P = .005; PA: rpartial = -0.23, P = .003). Engagement in PA ( rpartial = -0.19, 95% bootstrap CI, -0.34 to -0.03; P = .02) partially mediated the relationship between PSS and HRQoL ( rpartial = -0.18, 95% bootstrap CI, -0.35 to -0.01; P = .03) showing a 22% partial mediation with indirect effect at -0.05 (95% CI bootstrap, -0.11 to -0.002). CONCLUSION: Even among patients with high perceptions of hopelessness, better perceived social support and more engagement in physical activity are associated with better HRQoL. Longitudinal research in larger and more diverse samples is needed to examine the relationships among PSS, PA, and HRQoL in patients with IHD reporting hopelessness.

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