Integrating behavioral interventions into exercise rehabilitation for the well-being of patients with chronic heart failure
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Aspasia Pizga 1 , Panos Kordoutis 2 , Manal Al Shamari 1 , Dimitris Delis 1 , Vasiliki Linardatou 1 3 , Vasiliki Brouskeli 4 , Christina Routsi 5 , Eleni Magira 5 , Ioannis Vasileiadis 5 , Nikoletta Rovina 6 , Serafeim Nanas 1 , Eleftherios Karatzanos 1 *
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1 Clinical Ergospirometry, Exercise and Rehabilitation Laboratory, ‘Evangelismos’ General Hospital of Athens, Medical School, National and Kapodistrian University of Athens, Athens, GREECE2 Social Psychology of Interpersonal Relationships Department of Psychology, Panteion University of Social and Political Sciences, Athens, GREECE3 Nursing Education Office–Emergency & Critical care Nursing Specialty, General Hospital ‘G. Gennimatas’, Athens, GREECE4 Health Psychology, Department of Education Sciences in Early Childhood of the School of Education Sciences, Democritus University of Thrace, Komotini, GREECE5 First Critical Care Department, ‘Evangelismos’ General Hospital of Athens, Medical School, National and Kapodistrian University of Athens, GREECE6 Department of Pulmonary Medicine and Intensive Care Unit, Medical School, National and Kapodistrian University of Athens, GREECE* Corresponding Author

Abstract

Background: In recent years, the integration of psychological interventions into the rehabilitation of patients with chronic heart failure (CHF) has become more apparent. The effectiveness of these interventions varies, with some having a positive impact while others showing no effect. It is unclear which psychological interventions are considered effective for patients with heart failure.
Aim: We aimed to examine the impact of psychological interventions, encompassing psychoeducation, positive reinforcement, and stress management, on levels of stress, depression, and life satisfaction in patients with CHF.
Methods: Thirty-six consecutive CHF patients in stable condition (mean age: 56 ± 10 years, left ventricle ejection fraction < 50%) were randomly assigned to the intervention group (IG) (n = 18) or the control group (CG) (n = 18). All participants engaged in a structured rehabilitation program three times a week for a duration of 12 weeks. The IG received additional emotional support through 12 sessions of psychoeducation, stress resilience techniques, and positive behavior reinforcement. Measurements were conducted both pre- and post-intervention, with values expressed as mean and standard deviation.
Results: Following 12 weeks of rehabilitation, the IG demonstrated a substantial reduction in depression rates (from 3.4 [4.0] to 1.6 [2.4], p < 0.01), in contrast to the CG (from 3.6 [3.4] to 4.0 [3.7], p = 0.32). Stress levels were significantly diminished (p < 0.01) in both the IG (from 14.3 [8.6] to 9.1 [7.4]) and the CG (from 13.2 [9.8] to 8.6 [5.9]). Moreover, life satisfaction markedly increased in the IG (from 23.8 [5.2] to 30.8 [3.5], p < 0.01), while it decreased in the CG (from 26.0 [6.91] to 20.2 [6.5], p < 0.01). Noteworthy between-group differences were observed in depression rates and life satisfaction (p < 0.01).
Conclusions: Psychological interventions, alongside a structured exercise rehabilitation program, featuring psychoeducation, stress management techniques, and positive reinforcement, emerges as a potent strategy for alleviating depressive symptoms and enhancing the mental well-being of patients. This underscores the potential of a comprehensive approach that seamlessly integrates both physical and psychological interventions.

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Article Type: Research Article

ELECTRON J GEN MED, Volume 22, Issue 4, August 2025, Article No: em661

https://doi.org/10.29333/ejgm/16370

Publication date: 01 Jul 2025

Online publication date: 14 May 2025

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