Abstract
BACKGROUND: Patients with heart failure (HF) experience depressive symptoms that contribute to poorer outcomes. We tested the effects of a brief cognitive therapy intervention on depressive symptoms, negative thinking, health-related quality of life, and cardiac event-free survival. METHODS AND RESULTS: Hospitalized patients with depressive symptoms (n = 41, 66 ± 11 years, 45% female, 81% New York Heart Association Class III/IV) were randomly assigned to control group or a brief, nurse-delivered cognitive therapy intervention, delivered during hospitalization and followed by a 1-week booster phone call. Depressive symptoms, negative thinking, and health-related quality of life were measured at 1 week and 3 months. Cardiac event-free survival was assessed at 3 months. Mixed models repeated measures analysis of variance, Kaplan-Meier, and Cox regression were used for data analysis. There were significant improvements in depressive symptoms and health-related quality of life in both groups but no interactions between group and time. The control group had shorter 3-month cardiac event-free survival (40% versus 80%, P < .05) and a 3.5 greater hazard of experiencing a cardiac event (P = .04) than the intervention group. CONCLUSION: Nurses can deliver a brief intervention to hospitalized patients with heart failure that may improve short-term, event-free survival. Future research is needed to verify these results with a larger sample size.