This Mentored Patient-Oriented Research Career Development Award will enhance my ability to achieve my long-term career goal of becoming an independent cardiovascular nurse researcher with expertise in testing psychological interventions to improve biobehavioral outcomes of patients with heart failure (HF). One third of hospitalized patients with HF experience major depressive disorder, and up to half of patients experience depressive symptoms. Patients with HF and depressive symptoms have worse health-related quality of life and are twice as likely to be rehospitalized or die;thus there is a critical need to test interventions for the treatment of depressive symptoms in this population. In this project, I will receive formal training and mentorship in cognitive therapy and the conduct of clinical trials. I will use the skills and competencies I gain to complete the proposed randomized, controlled pilot study, which will test the feasibility and efficacy of nurse delivered cognitive therapy for depressive symptoms in patients who are hospitalized with HF. The intervention is an innovative, streamlined approach to cognitive therapy consisting of one brief 30-minute session initiated in-person during hospitalization and four 30-minute sessions delivered via phone after discharge. A total of 36 patients with HF who are hospitalized and experiencing moderate to severe depressive symptoms will be randomized to receive either the cognitive therapy intervention or usual care. Data demonstrating feasibility and efficacy of this interventio will be used to develop an R01 application to conduct a larger randomized controlled trial. This study will fill an important gap in the evidence base for depression treatment in patients with HF by demonstrating the feasibility and efficacy of a nurse-delivered, cognitive therapy intervention for hospitalized patients with HF. This contribution is significant because interventions designed to treat depressive symptoms may decrease the risk of hospital readmission and improve health-related quality of life among patients with HF who have depressive symptoms.

Public Health Relevance

People with heart failure often experience depressive symptoms which lead to poor quality of life and an increased risk of death and hospitalization. The intervention for depressive symptoms proposed in this project is designed to be delivered by nurses to a large number of patients. The knowledge gained from this project will help fulfill the need for new treatment strategies for depressive symptoms in people with heart failure that subsequently improve quality of life, lower risk of rehospitalization, and decrease health care costs.

National Institute of Health (NIH)
National Institute of Nursing Research (NINR)
Mentored Patient-Oriented Research Career Development Award (K23)
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Special Emphasis Panel (ZNR1)
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Huss, Karen
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University of Kentucky
Schools of Nursing
United States
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Alhurani, Abdullah S; Dekker, Rebecca; Ahmad, Muayyad et al. (2018) Stress, cognitive appraisal, coping, and event free survival in patients with heart failure. Heart Lung 47:205-210
Jeyanantham, Kishaan; Kotecha, Dipak; Thanki, Devsaagar et al. (2017) Effects of cognitive behavioural therapy for depression in heart failure patients: a systematic review and meta-analysis. Heart Fail Rev 22:731-741
Wierenga, Kelly L; Dekker, Rebecca L; Lennie, Terry A et al. (2017) African American Race Is Associated With Poorer Outcomes in Heart Failure Patients. West J Nurs Res 39:524-538
Dekker, Rebecca L; Lennie, Terry A; Moser, Debra K et al. (2017) Salivary Biomarkers, Oral Inflammation, and Functional Status in Patients With Heart Failure. Biol Res Nurs 19:153-161
Wu, Jia-Rong; Lee, Kyoung Suk; Dekker, Rebecca D et al. (2016) Prehospital Delay, Precipitants of Admission, and Length of Stay in Patients With Exacerbation of Heart Failure. Am J Crit Care 26:62-69
Alhurani, Abdullah S; Dekker, Rebecca L; Abed, Mona A et al. (2015) The association of co-morbid symptoms of depression and anxiety with all-cause mortality and cardiac rehospitalization in patients with heart failure. Psychosomatics 56:371-80
Heo, Seongkum; Moser, Debra K; Pressler, Susan J et al. (2014) Depressive symptoms and the relationship of inflammation to physical signs and symptoms in heart failure patients. Am J Crit Care 23:404-13
Alhurani, Abdullah S; Dekker, Rebecca; Tovar, Elizabeth et al. (2014) Examination of the potential association of stress with morbidity and mortality outcomes in patient with heart failure. SAGE Open Med 2:
Dekker, Rebecca L; Lennie, Terry A; Doering, Lynn V et al. (2014) Coexisting anxiety and depressive symptoms in patients with heart failure. Eur J Cardiovasc Nurs 13:168-76
Thylén, Ingela; Dekker, Rebecca L; Jaarsma, Tiny et al. (2014) Characteristics associated with anxiety, depressive symptoms, and quality-of-life in a large cohort of implantable cardioverter defibrillator recipients. J Psychosom Res 77:122-7

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