scholarly journals S20 Combining physical activity behavioural modification strategies alongside cognitive behavioural therapy during pulmonary rehabilitation in patients with COPD: An interim analysis of a pilot RCT

2021 ◽  
Author(s):  
M Armstrong ◽  
E Hume ◽  
L McNeillie ◽  
F Chambers ◽  
L Wakenshaw ◽  
...  
Keyword(s):  
Physical Activity ◽  
Cognitive Behavioural Therapy ◽  
Pulmonary Rehabilitation ◽  
Interim Analysis ◽  
Behavioural Therapy ◽  
Behavioural Modification ◽  
Cognitive Behavioural ◽  
Pilot Rct

scholarly journals Cognitive-behavioural therapy (CBT) for renal fatigue (BReF): a feasibility randomised-controlled trial of CBT for the management of fatigue in haemodialysis (HD) patients

BMJ Open ◽  
2018 ◽  
Vol 8 (3) ◽  
pp. e020842 ◽  
Author(s):  
Federica Picariello ◽  
Rona Moss-Morris ◽  
Iain C Macdougall ◽  
Sam Norton ◽  
Maria Da Silva-Gane ◽  
...  
Keyword(s):  
Physical Activity ◽  
Cognitive Behavioural Therapy ◽  
Controlled Trial ◽  
Behavioural Therapy ◽  
Self Report ◽  
Behavioural Responses ◽  
Feasibility Randomised Controlled Trial ◽  
Cognitive Behavioural ◽  
Potential Benefits ◽  
Randomised Controlled

IntroductionFatigue is one of the most common and disabling symptoms in end-stage kidney disease, particularly among in-centre haemodialysis patients. This two-arm parallel group feasibility randomised controlled trial will determine whether a fully powered efficacy trial is achievable by examining the feasibility of recruitment, acceptability and potential benefits of a cognitive-behavioural therapy (CBT)-based intervention for fatigue among in-centre haemodialysis patients.MethodsWe aim to recruit 40 adult patients undergoing in-centre haemodialysis at secondary care outpatient dialysis units, who meet clinical levels of fatigue. Patients will be randomised individually (using a 1:1 ratio) to either a 4–6 weeks’ CBT-based intervention (intervention arm) or to a waiting-list control (control arm). The primary feasibility outcomes include descriptive data on numbers within each recruiting centre meeting eligibility criteria, rates of recruitment, numbers retained postrandomisation and treatment adherence. To assess the potential benefits of the cognitive-behavioural therapy for renal fatigue intervention, secondary self-report outcomes include measures of fatigue severity (Chalder Fatigue Questionnaire), fatigue-related functional impairment (Work and Social Adjustment Scale), sleep quality (Pittsburgh Sleep Quality Index), depression (Patient Health Questionnaire-9) and anxiety (Generalised Anxiety Disorder-7). Changes in fatigue perceptions (Brief Illness Perception Questionnaire), cognitive and behavioural responses to fatigue (Cognitive and Behavioural Responses to Symptoms Questionnaire), sleep hygiene behaviours (Sleep Hygiene Index) and physical activity (International Physical Activity Questionnaire–short form) will also be explored. These self-report measures will be collected at baseline and 3 months postrandomisation. Nested qualitative interviews will be conducted postintervention to explore the acceptability of the intervention and identify any areas in need of improvement. The statistician and assessor will be blinded to treatment allocation.Ethics and disseminationA National Health Service (NHS) Research Ethics Committee approved the study. Any amendments to the protocol will be submitted to the NHS Committee and study sponsor.Trial registration numberISRCTN91238019;Pre-results.

Physical Activity of Patients With Chronic Pain Receiving Acceptance and Commitment Therapy or Cognitive Behavioural Therapy

2014 ◽  
Vol 31 (2) ◽  
pp. 131-143 ◽  
Author(s):  
Katherine VanBuskirk ◽  
Scott Roesch ◽  
Niloofar Afari ◽  
Julie Loebach Wetherell
Keyword(s):  
Physical Activity ◽  
Chronic Pain ◽  
Cognitive Behavioural Therapy ◽  
Acceptance And Commitment Therapy ◽  
Psychological Treatment ◽  
Behavioural Therapy ◽  
Tailored Interventions ◽  
Commitment Therapy ◽  
Acceptance And Commitment ◽  
Cognitive Behavioural

Physical activity is positively related to various indices of quality of life and is found to reduce symptoms in individuals with chronic pain. This manuscript presents findings from a post hoc analysis investigating whether treatment-related improvements from psychological treatment for chronic pain are mediated by changes in physical activity (PA). Secondary analyses sought to determine predictor variables of PA in patients with chronic pain and to determine the relationship between objective and self-report measurements of PA. The effect of psychological treatment on physical activity was assessed using accelerometers in a sample of participants with chronic pain in a randomised controlled trial comparing 8 weeks of acceptance and commitment therapy (ACT) to cognitive behavioural therapy (CBT). Participants wore actigraph accelerometers for 7 consecutive days at baseline, post-treatment, and at 6-month follow-up. Hierarchical linear modelling analyses found that the variance in physical activity was not significantly predicted by time (b = 104.67, p = .92) or treatment modality (b = −1659.34, p = .57). Women had greater increases in physical activity than did men (b = 6804.08, p = .02). Current ‘gold standard’ psychological treatments for chronic pain were not found to significantly increase physical activity, an important outcome to target in the treatment of physical and mental health. These results suggest that tailored interventions with greater emphasis on exercise may complement psychological treatment for chronic pain. In particular, gender-tailored interventions may capitalise on physical activity differences found between men and women.

The effect of Internet-delivered cognitive behavioural therapy vs. psychoeducation only on psychological distress in patients with non-cardiac chest pain: a randomized controlled trial (Preprint)

2021 ◽  
Author(s):  
Ghassan Mourad ◽  
Magda Eriksson-Liebon ◽  
Patric Karlström ◽  
Peter Johansson
Keyword(s):  
Physical Activity ◽  
Psychological Distress ◽  
Depressive Symptoms ◽  
Chest Pain ◽  
Cognitive Behavioural Therapy ◽  
Behavioural Therapy ◽  
Cardiac Anxiety ◽  
Cognitive Behavioural ◽  
Secondary Outcomes

BACKGROUND Patients with recurrent episodes of non-cardiac chest pain (NCCP) suffer from cardiac anxiety, as they misinterpret the pain to be cardiac-related and avoid physical activity that they think could threaten their lives. Psychological interventions, such as Internet-delivered cognitive behavioural therapy (iCBT), targeting anxiety can be a feasible solution by supporting patients to learn how to perceive and handle their chest pain. OBJECTIVE To evaluate the effects of a nurse-led iCBT program on cardiac anxiety and other patient-reported outcomes in patients with NCCP. METHODS Patients with at least two healthcare consultations due to NCCP during the last 6 months, and who were suffering from cardiac anxiety (Cardiac Anxiety Questionnaire (CAQ) score ≥24), were randomized into 5 weeks of iCBT (n=54) or psychoeducation (n=55). Patients were 54 (±17) vs 57 (±16) years old and mainly women (59% vs 64%). The iCBT program comprised psychoeducation, mindfulness, and exposure to physical activity, with weekly homework assignments. The primary outcome was cardiac anxiety. The secondary outcomes were fear of body sensations, depressive symptoms, health-related quality of life (HRQoL), and chest pain frequency. Intention-to-treat analysis was applied, and patients were followed-up for three months. A mixed model analysis was used to determine between-group differences in primary and secondary outcomes. RESULTS No significant differences were found between the iCBT and psychoeducation groups regarding cardiac anxiety or any of the secondary outcomes in terms of interaction effect of time and group over the 3-months follow-up. iCBT demonstrated a small effect size on cardiac anxiety (Cohen’s d=0.31). In the iCBT group, 16 patients (36%) reported a positive reliable change score (≥11 points on the CAQ), and thus an improvement in cardiac anxiety, to be compared with 13 patients (27 %) in the psychoeducation group. Within-group analysis showed further significant improvement in cardiac anxiety (p=.037), depressive symptoms (p=.007) and of NCCP frequency (p=.005) at 3-months follow-up compared to 5-weeks follow-up in the iCBT group, but not in the psychoeducation group. CONCLUSIONS iCBT was not superior to psychoeducation in decreasing cardiac anxiety in patients with NCCP. However, iCBT tends to have better long-term effects on psychological distress, including cardiac anxiety, HRQoL and NCCP frequency than psychoeducation. The effects need to be followed up in order to draw more reliable conclusions. CLINICALTRIAL The study was registered at ClinicalTrials.gov, NCT03336112; https://www.clinicaltrials.gov/ct2/show/NCT03336112

scholarly journals Trajectories and associations between depression and physical activity in patients with cardiovascular disease during participation in an internet-based cognitive behavioural therapy programme

2020 ◽  
pp. 147451512094725
Author(s):  
Peter Johansson ◽  
Erland Svensson ◽  
Gerhard Andersson ◽  
Johan Lundgren
Keyword(s):  
Physical Activity ◽  
Cardiovascular Disease ◽  
Depressive Symptoms ◽  
Cognitive Behavioural Therapy ◽  
Therapy Group ◽  
Behavioural Therapy ◽  
The Internet ◽  
Online Discussion Forum ◽  
Cognitive Behavioural

Background: There is a lack of knowledge about internet-based cognitive behavioural therapy in patients with cardiovascular disease, and its effects on depressive symptoms and physical activity. Aim: To examine trajectories of depressive symptoms and physical activity, and to explore if these trajectories are linked with the delivery of internet-based cognitive behavioural therapy. Methods: A secondary-analysis of data collected in a randomised controlled trial that evaluated the effects of a 9-week internet-based cognitive behavioural therapy programme compared to an online discussion forum on depressive symptoms in cardiovascular disease patients. Data were collected at baseline, once weekly during the 9-week intervention period and at the 9-week follow-up. The Montgomery Åsberg depression rating scale – self-rating (MADRS-S) was used to measure depressive symptoms. Two modified items from the physical activity questionnaire measuring frequency and length of physical activity were merged to form a physical activity factor. Results: After 2 weeks the internet-based cognitive behavioural therapy group had a temporary worsening in depressive symptoms. At 9-week follow-up, depressive symptoms ( P<0.001) and physical activity ( P=0.02) had improved more in the internet-based cognitive behavioural therapy group. Only in the internet-based cognitive behavioural therapy group, was a significant correlation ( r=–0.39, P=0.002) between changes in depressive symptoms and changes in physical activity found. Structural equation analyses revealed that internet-based cognitive behavioural therapy decreased depressive symptoms, and that a decrease in depression, in turn, resulted in an increase in physical activity. Conclusions: Internet-based cognitive behavioural therapy was more effective than an online discussion forum to decrease depressive symptoms and increase physical activity. Importantly, a decrease in depressive symptoms needs to precede an increase in physical activity.

Sign in / Sign up

Export Citation Format

Share Document