Evaluation of a Coping Effectiveness Training intervention in patients with chronic heart failure - a randomized controlled trial

被引:20
|
作者
Bose, Catarina Nahlen [1 ,2 ]
Persson, Hans [2 ]
Bjorling, Gunilla [1 ,2 ]
Ljunggren, Gunnar [3 ,4 ]
Elfstrom, Magnus L. [5 ]
Saboonchi, Fredrik [1 ,6 ]
机构
[1] Swedish Red Cross Univ Coll, PO 556 76, SE-10215 Stockholm, Sweden
[2] Karolinska Inst, Dept Clin Sci, Danderyd Hosp AB, SE-18288 Stockholm, Sweden
[3] Stockholm Cty Council, Publ Healthcare Serv Comm Adm, Stockholm, Sweden
[4] Karolinska Inst, Dept Learning Informat Management & Eth, Med Management Ctr, Stockholm, Sweden
[5] Malardalen Univ, Acad Hlth Care & Social Welf, Eskilstuna Vasteras, Sweden
[6] Karolinska Inst, Div Insurance Med, Dept Clin Neurosci, Stockholm, Sweden
关键词
Heart failure; intervention; randomized controlled trial; follow-up; sense of control; affect; QUALITY-OF-LIFE; PERCEIVED CONTROL; CLINICAL-TRIAL; BRIEF COPE; DEPRESSION; QUESTIONNAIRE; EDUCATION; SYMPTOMS; OUTCOMES; SUPPORT;
D O I
10.1177/1474515115625033
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Impaired emotional well-being has detrimental effects on health outcomes in patients with chronic heart failure (CHF). Aims: To evaluate a nurse-led Coping Effectiveness Training (CET) group intervention for patients with CHF. It was hypothesized that CET would increase emotional well-being (primary outcome) and health-related quality (HRQoL) of life and improve clinical outcomes. Furthermore, changes in appraisal and coping as mediators of the intervention effect were examined. Methods: Participants were randomized to either control group (n=51) receiving standard health care or CET intervention group (n=52). Self-assessments of positive affect, negative affect, depression, anxiety, HRQoL, illness perception, coping strategies and social support were performed pre- and post-intervention and after six weeks, six months and 12 months. Time to death and hospitalizations were measured during the entire follow-up (median 35 months, interquartile range 11 months). Results: No significant improvements for emotional well-being and HRQoL in the intervention group compared with the control group were found. After excluding patients with clinical anxiety and depression at baseline the intervention group had significantly lower negative affect (p = 0.022). There were no significant differences regarding cardiovascular events between the groups. The intervention group had greater sense of control over their illness in the short-term (p = 0.036). Conclusion: CET intervention was found to increase sense of control over the illness in the short term. Psychosocial support programmes, like CET, for patients with CHF is currently lacking evidence for implementing in clinical practice. However, the results provide a basis for future studies with a modified CET intervention design and increased study size.
引用
收藏
页码:537 / 548
页数:12
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