Associations between Forbearance and Health-Related Hope in Patients with Coronary Heart Disease: The Indirect Roles of Optimism and Resilience

Abstract

Objectives: This study aimed to examine the association between forbearance and health-related hope and to explore whether optimism and resilience function as indirect pathways in this relationship among patients with coronary heart disease. Methodology: A cross-sectional analytical study was conducted with 135 patients (mean age = 45.3 ± 14.2 years; 81 males and 54 females) diagnosed with coronary heart disease and recruited through purposive sampling from public and private hospitals. Standardized self-report measures were used, including the Forbearance Scale, Life Orientation Test–Revised, Brief Resilience Scale, and Health-Related Hope Scale. Data were analyzed using Pearson correlation and structural equation modeling with bootstrapping procedures to examine associations among variables. Results: Significant positive associations were observed among forbearance, optimism, resilience, and health-related hope. Structural equation modeling indicated that optimism and resilience were significantly associated with the relationship between forbearance and health-related hope through indirect pathways (β = 0.14, p = .007). The model demonstrated excellent fit indices. Conclusion: The findings suggest that forbearance is positively associated with health-related hope, and that optimism and resilience may serve as important psychological pathways in this association. These results highlight the potential value of incorporating psychological strengths into supportive interventions for patients with coronary heart disease. However, due to the cross-sectional design, causal inferences cannot be established.