IMPACT OF MOTIVATIONAL INTERVIEWING AND SKILLS-BASED COUNSELING ON OUTCOMES OF CARDIAC REHABILITATION

It is well known that in order to control the morbidity and mortality of cardiovascular disease patients, their lifestyle should be taken into account (American Heart Association, 2012; Klumbiene et al., 2002). Studies of various disease patients’ manners (Knight et al., 2006; Thompson et al., 2011) confirm that motivational interviewing (Miller & Rollnick, 2013) is an effective method for changing unhealthy behavior. Nevertheless, our practical experience of motivational interviewing based psychological counseling with rehabilitation hospitals’ cardiac patients’ (Sinkariova et al., 2015) revealed noteworthy observations about some participants lack of motivation to change unhealthy behavior. This observation encouraged us to start a study with the aim to find out if cardiac rehabilitation participants’ personality traits and emotional state are related to the effectiveness of motivational interviewing based psychological counseling. The study used a quasi-experiment where cardiac rehabilitation patients were assigned to control (regular rehabilitation, n=55) or experimental (rehabilitation plus motivational interviewing based psychological counseling intervention, n=64) groups. A total of 119 participants (male=83, female=36, M age=60.47, SD=8.762) attended a survey, which included NEO-FFI, HADs, and “Readiness to change questionnaire” at the beginning and end of cardiac rehabilitation. Nonparametric data analysis showed that patients’ personality traits are not related to the effectiveness of motivational interviewing based counseling, whereas depression is positively related to the effectiveness of intervention to change alcohol consumption. Conclusions/Implications: Depression as an expression of emotional state is an important feature for the effectiveness of motivational interviewing based counseling to change cardiac patients’ alcohol consumption. Further understanding of relationships between psychological characteristics and the effectiveness of intervention could help to improve cardiac diseases prevention, treatment, and rehabilitation.

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Effects of a Brief Motivational Interviewing Intervention on Adherence of Patients Undergoing Therapy in a Phase II Cardiac Rehabilitation Program

Internal Medicine Review ◽

10.18103/imr.v2i11.260 ◽

2016 ◽

Vol 2 (11) ◽

Author(s):

Rachel Sieke ◽

Angele McGrady ◽

Dalynn Badenhop

Keyword(s):

Cardiac Rehabilitation ◽

Motivational Interviewing ◽

Intervention Group ◽

Rehabilitation Program ◽

Program Completion ◽

Cardiac Rehabilitation Program ◽

Psychological Benefits ◽

Relaxation Intervention ◽

Potential Benefits ◽

And Control

<p>Patients who complete a structured cardiac rehabilitation program improve physical capacity and reduce distress. However, adherence to program completion ranges widely, and non -completion of cardiac rehabilitation jeopardizes the potential benefits. This study tests the effects of a brief motivational interviewing and relaxation intervention on completion of cardiac rehabilitation in patients referred to the program after a major cardiac event. One hundred four patients were recruited into this study and randomized to the control or a four session intervention group. Patients who completed the intervention were more likely to complete cardiac rehabilitation; specifically the number of sessions completed was significantly greater (p < 0.042) compared to controls. In addition to the intervention, baseline depression and anxiety are important predictors of dropout from rehabilitation. When entering the program, later completers had significantly lower depression (p < 0.009) and anxiety (p < 0.036) scores on standardized psychological inventories in contrast to those patients who later dropped out of rehabilitation. There were no differences in entry diagnosis or number of feet walked between later completers and non-completers. Patients in both the intervention and control groups who completed rehabilitation sustained important physical and psychological benefits. They were able to walk a greater distance and reduced scores on the anxiety and depression inventories.</p>

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Abstract P227: Psychosocial Predictors of Physical Capacity in Cardiac Rehabilitation

Circulation ◽

10.1161/circ.141.suppl_1.p227 ◽

2020 ◽

Vol 141 (Suppl_1) ◽

Author(s):

Binu Koirala ◽

Bronwyn Everett ◽

Yenna Salamonson ◽

Robert Zecchin ◽

Patricia Davidson

Keyword(s):

Social Support ◽

Cardiac Rehabilitation ◽

Motivational Interviewing ◽

Self Efficacy ◽

Controlled Trial ◽

Secondary Analysis ◽

Physical Capacity ◽

Psychosocial Predictors ◽

Chi Square ◽

Cardiac Control

Introduction: Despite the impressive gains achieved by those who attend cardiac rehabilitation, many patients fail to maintain the gains in physical capacity in the longer term. There are likely psychosocial characteristics that can be leveraged to sustain behavior change. Hypothesis: Patients with higher perceived cardiac control, social support, and exercise self-efficacy, without depression, and those who received motivational interviewing (MI) sessions, adjunctive to cardiac rehabilitation, will have a significantly higher physical capacity. Methods: This is a secondary analysis of the data from a randomized controlled trial of MI as a tool to enhance secondary prevention strategies in cardiovascular disease (MICIS study) conducted at three hospitals in Sydney, Australia who attended 6-week phase II cardiac rehabilitation. Two, 1-hour sessions of a nurse-delivered motivational interview focused on increasing physical capacity was implemented and the participants were followed at 6-weeks and 12-months. The outcome for the study was physical capacity measured by distance walked on the six-minute walk test (6MWT). Multiple imputations were used to handle missing data. Descriptive statistics, t-tests, chi-square tests and linear regression for cluster data were used for data analysis. Results: The mean (SD) age of participants (n=110) at baseline was 60.1 (10.57) years and the majority were male (71.8%). (Table). In the adjusted analysis, motivational interviewing (p =0.57), perceived cardiac control (p=0.30), self-efficacy for exercise (p = 0.06) and level of depressive symptoms were not related to 6MWT. With every unit increase in perceived social support score, there was a decrease in distance walked in 6MWT by 1.30 meters (b = -1.30; p= 0.007). Conclusion: In this sample, psychosocial predictors, except social support, were not likely to influence physical capacity. Investigating barriers and facilitators to sustaining the effects of cardiac rehabilitation are needed.

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