Gratitude in Post MI Patients Effects on Health Related Mood and Clinical Outcome

描述(由申请人提供)：每年有近80万美国人遭受首次心肌梗死(MI)，其中超过一半的人会有复发事件。有许多因素影响心肌梗死后的预后。除了生理因素，如最初的心肌梗死严重程度和对药物和心脏康复计划的坚持，心理社会因素对未来的临床病程具有很高的预测性。积极的情感，在MI事件中找到意义，在整个生活中找到意义，以及管理MI的后果和情绪痛苦是非常重要的。感恩通常被定义为一种感觉或态度 对一个人已经得到或将要得到的好处的承认，一种对生活积极方面的关注和欣赏的习惯。它与更高的主观幸福感水平有关，感恩的人经历的压力更小，抑郁更少，对环境的控制力更高，应对生活困难的方式更积极，消极应对策略更少。感恩与自我报告有关 身体健康，而这种联系是通过心理健康、健康活动和寻求健康帮助的意愿来调节的。临床上增加感恩的干预措施显示出了巨大的希望，展示了提高整体幸福感、生活意义以及与改善健康的潜在联系的能力。在113名首次心肌梗死后30天内的患者中， 这项拟议的探索性干预研究将检验与标准关怀(SOC)相结合的为期八周的感恩日记干预是否会增加积极的健康行为、心理健康和身体功能，与SOC加上记录值得纪念的事件和SOC相比。心理社会和临床评估将在六个月的时间内进行，测试在治疗前、治疗后立即和治疗后四个月进行。我们预计，这项研究的结果将：(A)科学地显示感恩与临床相关终点之间的因果关系的证据；(B)从疗法上提供一种新的干预方法，以便在这一心脏病人群中利用这些益处；(C)揭示自然和治疗效果的基础机制，这既是为了提高科学理解，也是为了以后开发更多量身定制的干预措施。

DESCRIPTION (provided by applicant): Every year, nearly 800,000 Americans endure a first myocardial infarction (MI), and over half of those will have a recurrent event. There are numerous factors that influence prognosis following an MI. In addition to physical factors, such as initial MI severity and adherence to medication and cardiac rehabilitation programs, psychosocial factors are highly predictive of future clinical course. Positive affect, finding meaning in the MI event, and in life in general, and managing the consequences and emotional distress of the MI are highly important. Gratitude is typically defined as a feeling or attitude in acknowledgment of a benefit that one has received or will receive, a habitual focusing on and appreciating the positive aspects of life. It is associated with higher levels of subjective well-being, and people who are more grateful experience less stress, are less depressed, have higher levels of control over their environment, have more positive ways of coping with life's difficulties, and have fewer negative coping strategies. Gratitude is correlated with self-reported physical health, and this link is mediated by psychological health, healthy activities, and willingness to seek help for health. Interventions to clinically increase gratitude have shown great promise, demonstrating the ability to increase overall sense of well-being, meaning in life, and potential associations with improved health. In 113 patients within 30 days of a first-time MI, this proposed exploratory intervention study will examine whether an eight-week gratitude journaling intervention coupled with standard of care (SOC), as compared to SOC plus journaling memorable events and SOC alone will increase positive health behaviors, psychological health, and physical functioning. Psychosocial and clinical assessments will be performed over a six-month period, with testing occurring before, immediately after, and four months after treatment. We envision the study's findings will (a) scientifically show evidence of causality in the relationship between gratitude and our clinically relevant endpoints, (b) therapeutically provide a new intervention methodology to harness these benefits in this cardiac population, and (c) show mechanisms that underlie both the natural and therapeutic effects, both to improve scientific understanding and to allow more tailored interventions to be developed at a later date.