Stress, cognitive appraisal, coping, and event free survival in patients with heart failure

Abdullah S. Alhurani, Rebecca Dekker, Muayyad Ahmad, Jennifer Miller, Khalil M. Yousef, Basel Abdulqader, Ibrahim Salami, Terry A. Lennie, David C. Randall, Debra K. Moser

Research output: Contribution to journalArticlepeer-review

28 Scopus citations


Objectives: To describe self-reported stress level, cognitive appraisal and coping among patients with heart failure (HF), and to examine the association of cognitive appraisal and coping strategies with event-free survival. Methods: This was a prospective, longitudinal, descriptive study of patients with chronic HF. Assessment of stress, cognitive appraisal, and coping was performed using Perceived Stress Scale, Cognitive Appraisal Health Scale, and Brief COPE scale, respectively. The event-free survival was defined as cardiac rehospitalization and all-cause death. Results: A total of 88 HF patients (mean age 58 ± 13 years and 53.4% male) participated. Linear and cox regression showed that harm/loss cognitive appraisal was associated with avoidant emotional coping (β = -0.28; 95% CI: -0.21 – 0.02; p = 0.02) and event free survival (HR = 0.53; 95% CI: 0.28 – 1.02; p = 0.05). Conclusions: The cognitive appraisal of the stressors related to HF may lead to negative coping strategies that are associated with worse event-free survival.

Original languageEnglish
Pages (from-to)205-210
Number of pages6
JournalHeart and Lung
Issue number3
StatePublished - May 1 2018

Bibliographical note

Publisher Copyright:
© 2018 Elsevier Inc.


  • Cognitive appraisal
  • Coping
  • Event-free survival
  • Heart failure
  • Stress

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine


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