Hope, morale and adaptation in patients with chronic heart failure

Clinical observation of a population of patients with chronic heart failure suggested that some patients adapt to their disease more effectively than others. This difference in response appeared to be more related to psychosocial variables, including a positive future orientation, than to variation in severity of disease. The purpose of this study was to investigate the relationship among the psychosocial variables of hope and morale, the level of function of the individual, and the physiological status of that individual. The sample for this descriptive study was patients who met inclusion criteria and who attended the Heart Failure Clinic at St Joseph's Hospital, Hamilton, Ontario, Canada (n = 23). Data were collected at one point in time. Population characteristics were obtained by chart extraction and patient interview. The Beck Hopelessness Scale, the Philadelphia Geriatric Centre Morale Scale, and an adapted version of the McMaster Health Status Index were administered. Physiological status was determined by clinical signs and symptoms in accordance with a scale devised by Lee. Patients who scored higher on the scales assessing hope and morale also scored higher on social function. There was very little relationship between these psychosocial variables and the physical variables of physiological status and physical function. These findings suggest that patients who are more hopeful maintain their involvement in life regardless of physical limitations imposed by their heart failure. Nursing interventions must continue to include the enhancement of hope for the future and active participation with others.