Resilience and treatment adhesion in patients with systemic lupus erythematosus

The effect of personalized mobile health (mHealth) in cardiac rehabilitation for discharged elderly patients after acute myocardial infarction on their inner strength and resilience

INTRODUCTION

Given the importance of promoting self-care and quality of life for discharged elderly patients after acute Myocardial Infarction(MI), It is necessitated we conduct interventions to promote these items. This study was conducted to determine the effect of mHealth-Cardiac rehabilitation (CR) on the inner Strength and resilience of elderly patients with MI after discharge from the hospital.

METHODS

The present study was a randomized controlled trial that was conducted on 56 Elderly patients with myocardial infarction were discharged from the heart departments. In the intervention group after the patient's discharge, the patients were contacted twice a week for one month and the necessary training and support were given online. To gather data, the Mini-Mental State Examination (MMSE), the demographic and clinical characteristics questionnaire, the inner strength scale (ISS), and the Connor-Davidson Resilience Scale (CD-RISC) were completed pre- and post-intervention. The data analysis was done by SPSS16.

RESULTS

This study showed the mean resilience and inner strength scores before and after the intervention in the control group had no statistically significant difference(P˃0.05). There was a significant increase in the mean resilience and inner strength scores in the intervention group after the intervention (P ≤ 0.001).

CONCLUSION

The results of this study showed that mHealth as a kind of telenursing nursing has a significant effect on both variables of inner strength and resilience of post-discharge elderly patients after acute myocardial infarction. This means that using mHealth for these patients could increase the inner strength and resilience of the elderly discharged after myocardial infarction. Therefore, through using this method, elderly patients' self-care ability and quality of life could be increased.

Resilience and its associations in children with Systemic Lupus Erythematosus and Juvenile Idiopathic Arthritis

BACKGROUND

Resilience has been shown to be associated with better psychological outcomes and ability to cope with negative and traumatic events in the healthcare setting. Therefore, in this study, we aimed to evaluate resilience and its association with disease activity and health-related quality of life (HRQOL) in children with Systemic Lupus Erythematosus (SLE) and Juvenile Idiopathic Arthritis (JIA).

FINDINGS

Patients with diagnoses of SLE or JIA were recruited. We collected: demographic data, medical history and physical examination, physician and patient global health assessments, Patient Reported Outcome Measurement Information System questionnaires, Connor Davidson Resilience Scale 10 (CD-RISC 10), Systemic Lupus Erythematosus Disease Activity Index, and clinical Juvenile Arthritis Disease Activity Score 10. Descriptive statistics were calculated, and PROMIS raw scores were converted to T-scores. Spearman's correlations were performed, with statistical significance set to p < 0.05. 47 study subjects were recruited. The average CD-RISC 10 score in SLE was 24.4, and in JIA was 25.2. In children with SLE, CD-RISC 10 was correlated with disease activity and inversely correlated with anxiety. In children with JIA, resilience was inversely associated with fatigue, and positively correlated with mobility and peer relationships.

CONCLUSIONS

In children with SLE and JIA, resilience is lower than in the general population. Further, our results suggest that interventions to increase resilience may improve the HRQOL of children with rheumatic disease. Ongoing study of the importance of resilience in this population, as well as interventions to increase resilience, will be an important area of future research in children with SLE and JIA.

Threat Appraisal, Resilience, and Health Behaviors in Recovered COVID-19 Patients: The Serial Mediation of Coping and Meaning-Making

Research indicates that both cognitive appraisal and personal resources can noticeably influence health behaviors, as individuals modify their health convictions and practices on the basis of threat appraisal, personality, and meaning. The aim of the current study was to investigate whether coping strategies and meaning-making can serially mediate the relationship of threat appraisal and resilience with health behaviors in recovered COVID-19 patients. Self-report measures of threat appraisal, resilience, coping, meaning-making, and health behaviors were completed by 266 participants (aged 17 to 78, 51.5% female) who had recovered from COVID-19. The serial mediation analysis showed that the relationship of threat appraisal and resilience with health behaviors was mediated by problem-focused coping, meaning-focused coping, and meaning-making, but not by emotion-focused coping. These results suggest that associations among threat perception, resilience, and health behavior depend to some extent on the interplay of coping and meaning-making, which reveals their unique role in the process of recovery from COVID-19, with potential implications for health interventions.

School bullying among Chinese third to fifth grade primary school students in a cross-sectional study: The protective effect of psychological resilience

School bullying is a major concern for school-aged youth and has great impacts on children's health and well-being, and an increasing number of school bullying cases have been reported in China. Many studies have indicated that psychological resilience may have a well-established association with school bullying. However, only a limited number of studies have explored this association, especially among primary school students. The present study aimed to investigate the relationship between school bullying and psychological resilience among primary school students from a Chinese city. The participants were 6,011 primary school students aged 7-14 years who were recruited in a cross-sectional survey in Luzhou, China. The statistical significance of differences between groups was tested using the χ2 test or t test. Binary logistic regression analyses were conducted to explore the association between psychological resilience and school bullying. The incidence rates of bullies and victims were 30.00% (1803/6011; 95% CI: 28.84%-31.16%) and 69.89% (4201/6011; 95% CI: 68.73%-71.05%), respectively. Psychological resilience was a protective factor of school bullying among primary school students (for bullying perpetrators, OR = 0.76, 95%CI:0.62-0.93, and for bully victims OR = 0.74, 95%CI:0.61-0.90), especially among female students (for bullying perpetrators, OR = 0.63, 95%CI: 0.47-0.85, and for bully victims, OR = 0.69, 95%CI: 0.53-0.90). School bullying among primary school students in Luzhou City was highly prevalent. High levels of psychological resilience might be a protective factor in preventing primary students from being involved in school bullying, especially among females.

Psychological Resilience May Be Related to Students' Responses to Victims of School Bullying: A Cross-Sectional Study of Chinese Grade 3-5 Primary School Students

BACKGROUND

School bullying is a major public health problem with a large impact on children's health. There is an increasing number of cases of school bullying reported in China. Studies have shown that the health consequences of different ways of responding to school bullying may be quite different and that psychological resilience is also closely related to aggressive behaviors. However, there has been little research on whether individuals with different psychological resilience levels respond differently.

OBJECTIVE

To explore the relationship between responses to school bullying and psychological resilience, which may provide new ideas and strategies to better prevent and intervene in school bullying.

METHODS

A random sample of 5425 primary school students aged 7-14 years were recruited in Luzhou, China. All students completed a questionnaire anonymously. The statistical significance of differences between groups was tested using the χ² test or t test. Binary logistic regression was conducted to explore the relationship between responses and psychological resilience.

RESULTS

Over two-thirds of primary school students in this study reported experiencing bullying in the past year. The rate of positive responses among victims was 69.10% (2596/3757, 95% CI: 67.62~70.58%). There was a positive relationship between psychological resilience and positive responses. This relationship was observed for all victims (OR = 1.605, 95% CI: 1.254~2.055), especially male victims (OR = 2.300, 95% CI: 1.624~3.259).

CONCLUSIONS

There was a positive relationship between primary school bullying responses and psychological resilience among victims, with differences by sex. Therefore, increasing students' level of psychological resilience, possibly by improving their responses, is important for preventing school bullying. Meanwhile, effective interventions for school bullying should be developed from multiple perspectives, particularly sex, bullying roles, and psychological resilience.

Psychological Effects of Lockdown Measures for the COVID-19 Outbreak in Patients with Systemic Lupus Erythematosus

Objective

To compare the psychological impact of the lockdown measures contrasting the COVID-19 outbreak between systemic lupus erythematosus (SLE) and general population.

Patients and Methods

From July 15th to August 15th 2020, a retrospective survey referring to the period March 9th to May 18th 2020 was administered to SLE patients and the results of the survey, called LEPRE (Lupus Erythematosus PREsto) study, were compared with those from the PRESTO (imPact of quaRantine mEasures againST cOvid19) project, the same survey provided to the general population. Consecutive patients >18 years old affected by SLE and regularly followed in a single rheumatologic centre were involved. Primary outcome was to compare the scores of the Impact of Events Scale-Revised (IES-R), the General Health Questionnaire 12 (GHQ-12) and the Center for Epidemiological Depression Scale (CES-D) between patients and general population.

Results

A total of 64 patients completed the survey. After a propensity score matching, they were compared to 128 people from PRESTO project. The median age among patients was 43 years (I–III interquartile range 35–54.5), 88% were female and 100% Caucasian. IES-R [(score>23: 57% (34) vs 49% (58)], GHQ-12 [(score>13: 85% (52) vs 88% (106)], and CES-D [(score>15: 45% (28) vs 40% (46)] scores were not statistically different between patients and controls (p>0.05).

Conclusion

Restrictive measures for COVID-19 pandemic had no greater impact on patients with SLE than in the general population. Strategy for coping to the SLE might be useful during lockdown measures and may be helpful for other chronic conditions.

Resilience in women with primary Sjögren's syndrome

To assess the relationship between resilience and several diseases and individual features in primary Sjӧgren's Syndrome (SS) patients. Resilience was assessed using the Resilience Scale (RS-14). Disease activity, damage, and reported symptoms were assessed by means of ESSDAI (EULAR Sjögren's syndrome disease activity index), SSDDI (Sjӧgren's Syndrome Disease Damage Index) and ESSPRI (EULAR Sjӧgren's Syndrome Patient Reported Index). EuroQol, HADS (Hospital Anxiety and Depression Scale), SF-12 (Short-form 12 health survey), FAS (Fatigue Assessment Scale), FACIT-F (Functional Assessment of Chronic Illness Therapy - Fatigue), and IPAQ (International Physical Activity Questionnaire) questionnaires were submitted to evaluate physical and mental well-being of the recruited patients. Data about the autoimmune profile, systemic manifestations, and current therapy were collected. Educational qualifications and work activities were also considered. Descriptive, correlational, and linear regression analysis were performed. 74 consecutive women with primary SS and 74 sex and age-matched healthy subjects as a control group were recruited. SS patients displayed a moderate value of resilience (median 78.5) with no significant difference compared to controls (p = 0.38). An inverse relationship was found between resilience and mood disorders such as anxiety (p = 0.038) and depression (p < 0.001). Greater resilience was associated with a better perception of the quality of life (p = 0.02) and general health (p < 0.001), as well as with less fatigue (p = 0.008) and a more physically active lifestyle (p = 0.001). No significant relationship was found neither between resilience and age, socio-demographic and disease characteristics, nor with ESSDAI (p = 0.26), ESSPRI (p = 0.83) and SSDDI (p = 0.67). This is the first study assessing resilience in a large group of unselected primary SS patients. Most resilient primary SS patients are less depressed and show a better perception of their health. Greater resilience tends to correlate with less anxiety, physical and mental fatigue, and a more active lifestyle, while no association with disease activity and duration, damage, and socio-demographic features was detected. Considering the well-known role of resilience in helping to better cope with chronic illnesses, its assessment in SS patients should not be overlooked and the possible strategies for its improvement should be better explored and further implemented.

Medication adherence is influenced by resilience in patients with systemic lupus erythematosus

OBJECTIVE

Evidence on the relationship between resilience and medication adherence in systemic lupus erythematosus (SLE) patients is lacking. We aimed to examine the impact of resilience on medication adherence in SLE patients.

METHOD

In a cross-sectional analysis SLE outpatients were assessed for resilience (Connor-Davison Resilience Scale, CD-RISC), depressive symptoms (CES-D) and medication adherence (Compliance Questionnaire for Rheumatology [CQR]). The disease activity index (mexSLEDAI) and damage (SLICC Damage Index) were administered. Factors independently associated with adherence were identified using multivariate logistic regression.

RESULTS

Of the 157 patients, 152 (96.8%) were female with a median age of 45.9 (IQR: 39.0-55.5) years and disease duration of 14 (IQR: 10.0-19.0) years. Medication adherence (CQR ≥80%) and depressive symptoms were found in 74.5% and 43.9% of patients, respectively. Adherent patients had a lower CES-D score and a higher CD-RISC score. In the multivariate analysis adjusting for demographic and clinical confounders, resilience and older age protected against non-adherence (OR 0.96, [95% CI 0.94-0.99] and OR 0.96 [95% CI 0.93-0.98], respectively).

CONCLUSION

In SLE patients, resilience and older age, which possibly associated with better medication adherence, may protect against non-adherence.

Clinical Team Perspectives on the Psychosocial Aspects of Transition to Adult Care for Patients With Childhood-Onset Systemic Lupus Erythematosus

OBJECTIVE

The transition from pediatric to adult care for youth with childhood-onset systemic lupus erythematosus (SLE) is a vulnerable period. Adverse outcomes during this transition include gaps in care, unscheduled health care utilization, loss of insurance, and high disease activity. The objective of this study was to examine the clinical care teams' perspective on the psychosocial factors associated with transition outcomes, which are poorly understood in this population.

METHODS

We conducted in-depth interviews with clinical care team members who interact with childhood-onset SLE patients during transfer from pediatric to adult rheumatology. A semistructured interview guide was used to prompt participants' perspectives about the psychosocial factors associated with the transition process for patients with childhood-onset SLE. Audio recordings were transcribed and analyzed using the constant comparative method. We stopped conducting interviews once thematic saturation was achieved.

RESULTS

Thirteen in-depth interviews were conducted. Participants included pediatric rheumatologists (n = 4), adult rheumatologists from both academic and private practice settings (n = 4), nurses (n = 2), a nurse practitioner, a social worker, and a psychologist. We identified several themes deemed by clinical care teams as important during the transition, including the impact of the family, patient resilience and coping mechanisms, the role of mental health and emotional support, and the need for education, peer support, and social connectedness.

CONCLUSION

We identified several psychosocial themes that clinical team members believe impact the transition of patients with childhood-onset SLE into adult care. The role of parental modeling, youth resilience, mental health and emotional care, improved childhood-onset SLE education, and structured peer support and social connectedness are highlighted, which may be amenable to interventions.

Resilience of patients with chronic diseases: A systematic review

The purpose of this research was to contribute to the development of a resilience-promoting programme for patients with chronic diseases. A systematic review of literature concerning resilience interventions for patients with chronic diseases was conducted by searching PubMed (including Medline), Science Direct, Web of Science, PsycARTICLES, CINAHL Plus, Embase, and the Cochrane Database for articles featuring the terms "resilience," "resiliency," "resilient," "cancer," "stroke," "heart disease," "diabetes" and "COPD" and published between 8 January 2017 and 15 January 2017. We included all English studies relevant to the topic; however, we excluded: (1) nonrandomised controlled trials and (2) those that mentioned the term "resilience" but did not apply it in their analysis. Seventeen studies-10 on cancer, four on cardiovascular diseases and three on diabetes-were deemed suitable for analysis. We found that, in these studies, (1) diverse definitions of resilience were applied, (2) various intervention durations were used and (3) complex programmes were applied within the resilience-improving programmes. Our research encourages efforts to operationalise the construct of resilience, so it can be applied in clinical settings, and for the development of more systematic intervention programmes.

Associations between resilience and sociodemographic factors and depressive symptoms in women with systemic lupus erythematosus

OBJECTIVE

To compare resilience in women with SLE and healthy women and determine whether sociodemographic factors and depressive symptoms were associated with resilience in patients with SLE.

METHODS

This was a cross-sectional study. Participants were 123 women with SLE according to the ACR criteria and 132 age-matched healthy women (median = 45 (IQR = 34-54) years). Scales administered were: SLEDAI-2 K for disease activity, Graffar method, SLICC damage index, Center for Epidemiologic Studies Depression Scale, and the Spanish version of the Resilience Scale of Wagnild and Young. The statistical analysis was made using the Student t, Mann Whitney, Chi-square, and Spearman's Rho tests and multivariate analysis with a generalized linear model (GLM). Statistical significance was set as p < .05.

RESULTS

There were no differences in resilience scores between women with SLE and healthy women (median = 80, IQR = 75-87 vs. median = 80, IQR = 74-86.75, p = .38), although patients with SLE had higher self-efficacy scores (median = 47 IQR = 43-50 vs. median = 45, IQR = 42-48, p = .002) and depressive symptoms (median = 10, IQR = 5-18 vs. median = 8, IQR = 5-18, p = .01). The overall resilience score correlated with depressive symptoms (r = -0.537, p < .01). The GLM showed no association between sociodemographic factors and resilience in patients with SLE.

CONCLUSIONS

Resilience did not differ between women with SLE and healthy women. In patients with SLE, depressive symptoms may influence resilience and its domains, but sociodemographic factors do not.

PUBLIC HEALTH SIGNIFICANCE STATEMENT

The results suggest that resilience was similar between females with systemic lupus erythematosus (SLE) and age-matched healthy women. Depressive symptoms correlated negatively with resilience in patients with SLE. Sociodemographic factors were not associated with resilience in patients with SLE.

Resilience in women with autoimmune rheumatic diseases

OBJECTIVE

To evaluate the relationship between resilience and clinical outcomes in patients with autoimmune rheumatic diseases.

METHODS

Focus groups, individual interviews, and chart reviews were done to collect data on 188 women with autoimmune rheumatic diseases, namely rheumatoid arthritis (n=51), systemic lupus erythematosus (n=70), systemic sclerosis (n=35), and Sjögren's syndrome (n=32). Demographic, clinical, and laboratory variables were assessed including disease activity by patient reported outcomes. Resilience was evaluated by using the Brief Resilience Scale. Bivariate, multiple linear regression, and classification and regression trees were used to analyse data.

RESULTS

Resilience was influenced by age, duration of disease, and socioeconomic status. Lower resilience scores were observed in younger patients (<48years) with systemic lupus erythematosus, rheumatoid arthritis, and systemic sclerosis who had low socioeconomic status, whereas older patients (>50years) had higher resilience scores regardless of socioeconomic status. There was no influence of disease activity on resilience. A particular behaviour was observed in systemic sclerosis in which patients with high socioeconomic status and regular physical activity had higher resilience scores.

CONCLUSION

Resilience in patients with autoimmune rheumatic diseases is a continuum process influenced by age and socioeconomic status. The ways in which these variables along with exercise influence resilience deserve further investigation.

Cyclophosphamide administration routine in autoimmune rheumatic diseases: a review

Cyclophosphamide is an alkylating agent widely used for the treatment of malignant neoplasia and which can be used in the treatment of multiple rheumatic diseases. Medication administration errors may lead to its reduced efficacy or increased drug toxicity. Many errors occur in the administration of injectable drugs. The present study aimed at structuring a routine for cyclophosphamide use, as well as creating a document with pharmacotherapeutic guidelines for the patient. The routine is schematized in three phases: pre-chemotherapy, administration of cyclophosphamide, and post-chemotherapy, taking into account the drugs to be administered before and after cyclophosphamide in order to prevent adverse effects, including nausea and hemorrhagic cystitis. Adverse reactions can alter laboratory tests; thus, this routine included clinical management for changes in white blood cells, platelets, neutrophils, and sodium, including cyclophosphamide dose adjustment in the case of kidney disease. Cyclophosphamide is responsible for other rare - but serious - side effects, for instance, hepatotoxicity, severe hyponatremia and heart failure. Other adverse reactions include hair loss, amenorrhea and menopause. In this routine, we also entered guidelines to post-chemotherapy patients. The compatibility of injectable drugs with the vehicle used has been described, as well as stability and infusion times. The routine aimed at the rational use of cyclophosphamide, with prevention of adverse events and relapse episodes, factors that may burden the health care system.

Association between frequency of fried food consumption and resilience to depression in Japanese company workers: a cross-sectional study

Background

Long-chain n-3 and n-6 polyunsaturated fatty acids (LC n-3/n-6 PUFA) play important roles in emotional regulation. We previously reported an association between fish consumption, which is major source of LC n-3 PUFA, and resilience to depression, where resilience is the ability to cope with stress in the face of adversity. Although the traditional Japanese dietary pattern of high fish consumption is associated with low depressive symptoms, the current Japanese diet pattern has become westernized. Westernized diets contain excessive amounts of LC n-6 PUFA due to high intake of vegetable oils commonly used in fried food and are associated with risk of depression. The aim of this study was to examine the association between frequency of fried food consumption and resilience to depression.

Methods

Participants were 715 Japanese company workers. The Center for Epidemiologic Studies Depression Scale (CES-D) was used to measure depressive symptoms, and the 14-item Resilience Scale (RS-14) was used to measure resilience. Frequency of fish and fried food consumption was assessed using a self-report questionnaire based on the Food Frequency Questionnaire. Regression analyses using Preacher and Hayes’ bootstrap script were used to adjust for demographic factors, frequency of physical exercise, and fish consumption.

Results

Significant associations were identified between frequency of fried food consumption and total CES-D score (path c, B = 0.72; P < 0.01), between frequency of fried food consumption and total RS-14 score (path a, B = −1.73, P < 0.01), and between total RS-14 score and CES-D score (path b, B = −0.35; P < 0.01). The association between fried food consumption and total CES-D score was not significant when we controlled for RS-14 score. Bootstrapping results showed that there was a significant positive indirect association between frequency of fried food and CESD score through RS-14 (95 % bias-corrected and accelerated confidence interval = 0.34 to 0.92).

Conclusion

Frequency of fried food consumption was associated with lower resilience to depression. Further nutritional interventional studies to increase resilience and prevent depression are warranted.

Measurement properties of the brief resilient coping scale in patients with systemic lupus erythematosus using rasch analysis

Bacground

Resilience has been defined as the capacity or the ability to rebound from and positively adapt to significant stressors, despite experiences of significant adversity or trauma. To capture to what extent an individual copes with stress in a resilient fashion the Brief Resilient Coping Scale (BRCS) was developed. This tool was validated in people with chronic disease, such as rheumatoid arthritis using standard psychometric techniques of classical test theory, but not yet in patients with Systemic lupus erythematosus (SLE). The aim of this study was to explore the psychometric properties of the Brief Resilient Coping Scale in patients with SLE using Rasch analysis.

Method

This study used cross-sectional data. The BRCS was administered to 232 patients with systemic lupus erythematosus. The aspects analyzed were unidimensionality, local independence and differential item functioning (DIF) to construct an interpretative scale of scores with the Rasch model.

Results

Rating scale mode (RSM) showed that the four categories used in the items of the BRCS are properly ordered. The four items provided a good fit to the polytomous Rasch model. Moreover, the parameters were sufficiently separated to measure resilience in patients with SLE. BRCS is a unidimensional scale (eigenvalue = 1.843) of resilience and the items were locally independent. There was no DIF between males and females in the sample. Only marginally significant differences depending on the level of education were found. The BRCS showed adequate discriminant validity between groups of scores.

Conclusions

BRCS is a suitable scale for measuring resilience in patients with SLE. This scale might be useful for clinicians to obtain information concerning the degree of resilience that each patient has, allowing individuals with low resilience to be identified who need interventions aimed at developing coping skills.

Resilience of Patients With Chronic Physical Diseases: A Systematic Review and Meta-Analysis

Context

Resilience can be seen as an adaption to stress, such as that caused by health problems or disease, that attenuates the negative effects of stress. The present research performed a systematic review and meta-analysis to study resilience scores among adults diagnosed with chronic physical diseases.

Evidence Acquisition

Electronic databases, including Persian language (scientific information database [SID], IranMedex, Magiran, IranDoc, and Medlib) and English language (Google Scholar, Science Direct, PubMed, Pre-Quest, and Scopus), were searched. Fifteen articles were found using the keywords disease or chronic disease, resilience or resiliency, and illness, either alone or in combination, both in Persian and English languages. Data analysis was carried out through meta-analysis (random-effects model), and heterogeneity was investigated by subgroup and meta-regression analyses. The data were analyzed in STAT software (12.0).

Results

The mean resilience score of the chronic disease patients (n = 3369) was 74.6 (95% CI: 51.8 - 97.4). In terms of diseases, the mean resilience score of cancer patients was 79.6 (95% CI: 48.3 - 111.1), whereas it was 79.6 for cardiovascular disease patients (95% CI: 45.8 - 113.3) and 64.6 for patients with other diseases (95% CI: 6.6 - 122.7). There was no relationship between the resilience of chronic disease patients and the year of the study (P = 0.711) and the sample size in the studies (P = 0.351).

Conclusions

The mean resilience score of the patients was less than that of healthy individuals. As resilience can be acquired at any stage of life, irrespective of age and disease status, there is a need for training to improve resilience among patients through educational programs.

Resilience in Patients with Ischemic Heart Disease

BACKGROUND

Resilience is a psychosocial factor associated with clinical outcomes in chronic diseases. The relationship between this protective factor and certain diseases, such heart diseases, is still under-explored.

OBJECTIVE

The present study sought to investigate the frequency of resilience in individuals with ischemic heart disease.

METHOD

This was a cross-sectional study with 133 patients of both genders, aged between 35 and 65 years, treated at Rio Grande do Sul Cardiology Institute - Cardiology University Foundation, with a diagnosis of ischemic heart disease during the study period. Sixty-seven patients had a history of acute myocardial infarction. The individuals were interviewed and evaluated by the Wagnild & Young resilience scale and a sociodemographic questionnaire.

RESULTS

Eighty-one percent of patients were classified as resilient according to the scale.

CONCLUSION

In the sample studied, resilience was identified in high proportion among patients with ischemic heart disease.