Brief Strategic Therapy and Motivational Interviewing among Cardiac Rehabilitation Patients: pre-post treatment results

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.

Download Full-text

A comparative study of SAM and ADDIE models in simulating STEM instruction

African Educational Research Journal ◽

10.30918/aerj.94.21.125 ◽

2021 ◽

Vol 9 (4) ◽

pp. 852-859

Author(s):

Clement Ayarebilla Ali ◽

Keyword(s):

Student Teachers ◽

Successive Approximation ◽

Teaching And Learning ◽

Post Treatment ◽

Approximation Model ◽

Treatment Results ◽

Pre Treatment ◽

Addie Model ◽

And Mathematics ◽

Mathematics And Science

The study compared exhaustively the Successive Approximation Model (SAM) and Analyze, Design, Develop, Implement and Evaluate (ADDIE) model on the teaching and learning of Science, Technology, Engineering and Mathematics subjects in Ghana. We selected a sample of 30 student-teachers who offered Mathematics and Science in the distance mode of the University of Education, Winneba, Ghana in the 2018/2019 academic year. The first stage of the analysis compared the models separately within the Vygotskian framework using pre-post experiemtal design. The second stage made comparisons between and within the two models. The results of both stages showed that student-teachers preferred mostly SAM to ADDIE instructional models. There were not only consistently higher mean gains in the latter model, but the group averages of student-teachers in the post-treatment results also demonstrated clear improvements. Again, student-teachers showed tremendous improvements in the conceptual understanding of both models. However, the Successive Approximation Model recorded much more improvements in both pre-treatment and post-treatment results. It was therefore imperative to conclude that the Successive Approximation Model was more properly situated in the context of teaching and learning Mathematics and Science. We, therefore, recommended experimental explorations of SAM for STEM.

Download Full-text

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>

Download Full-text

Heart-Rate Changes in Improved Spider-Phobic Patients

Psychological Reports ◽

10.2466/pr0.1977.41.2.667 ◽

1977 ◽

Vol 41 (2) ◽

pp. 667-671 ◽

Cited By ~ 6

Author(s):

C. B. Taylor

Keyword(s):

Heart Rate ◽

Therapeutic Approach ◽

Post Treatment ◽

Physiological Changes ◽

Treatment Results ◽

Heart Rates ◽

Before And After ◽

Behavioral Improvement

Two spider-phobic patients were treated with a participant-modeling therapeutic approach. Continuous ambulatory heart rates were measured before and after treatment on a spider course laid out so that subjects encountered a variety of spider-related stimuli and environs. Heart rates were also measured during treatment. Despite behavioral improvement pre- to post-treatment for both subjects, the two subjects' heart rates exhibited opposite effects pre- to post-treatment, results consistent with the notion that behavioral improvement and physiological changes do not necessarily occur simultaneously in phobic subjects.

Download Full-text

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

Journal of Cardiopulmonary Rehabilitation ◽

10.1097/00008483-199709000-00014 ◽

1997 ◽

Vol 17 (5) ◽

pp. 328 ◽

Cited By ~ 3

Author(s):

Robert Scales ◽

Richard D. Lueker ◽

Hemming A. Atterbom ◽

Nancy S. Handmaker ◽

Kathleen A. Jackson

Keyword(s):

Cardiac Rehabilitation ◽

Motivational Interviewing

Download Full-text

The Brief Strategic Treatment of Cardiophobia: A Clinical Case Study

Journal of Contemporary Psychotherapy ◽

10.1007/s10879-020-09479-z ◽

2020 ◽

Author(s):

Giada Pietrabissa ◽

Federica Rozzoni ◽

Flavia Liguori ◽

Antonella Cerruto ◽

Emanuele Maria Giusti ◽

...

Keyword(s):

Cardiac Rehabilitation ◽

Mood State ◽

Systematic Research ◽

Clinical Case Study ◽

Strategic Approach ◽

End Of Treatment ◽

Bodily Sensations ◽

Brief Strategic Therapy ◽

Therapeutic Encounter ◽

First Time

AbstractMany individuals presenting to medical settings with heart-related symptoms for which no medical explanation is found might suffer from cardiophobia, but this condition is still poorly identified and addressed. This article presents a case of cardiophobia treated in an outpatient cardiac rehabilitation unit and, for the first time, describes the application of brief strategic therapy for the treatment of this condition. In the case reported, the first therapeutic encounter and the key elements of the strategic approach are described in detail with the aim to explain how brief strategic therapy works and how it can be used to identify and address cardiophobia-related behaviors. A 64-year-old male presented to cardiac rehabilitation reporting intense anxiety-provoking heart palpitations, and believing he was at risk of dying from a heart attack. After 3 sessions, an overall improvement in heart-related bodily sensations followed a decrease in the patient’s continuous checking of his heartbeat and seeking reassurance—factors that were largely responsible for the persistence of the problem. Moreover, quantitative evaluation showed increased scores of mood state at the end of treatment. This improvement persisted at the 18-month follow-up. This case is an interesting example of how brief strategic therapy can contribute to the development of a new conceptual model for the diagnosis and treatment of cardiophobia. Still, more systematic research in the field is needed to prove the efficacy and effectiveness of this therapeutic approach on symptoms of heart-focused anxiety.

Download Full-text

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.

Download Full-text

ASSESSMENT OF MOTIVATIONAL INTERVIEWING PROFICIENCY IN CARDIAC REHABILITATION

Journal of Cardiopulmonary Rehabilitation and Prevention ◽

10.1097/01.hcr.0000327215.52885.f0 ◽

2008 ◽

Vol 28 (4) ◽

pp. 275 ◽

Cited By ~ 1

Author(s):

Robert Scales ◽

Erin Hartlein ◽

Jennifer K. Manuel ◽

Rebecca L. Kelly ◽

Joseph H. Miller ◽

...

Keyword(s):

Cardiac Rehabilitation ◽

Motivational Interviewing

Download Full-text

The use of peripheral blood cells as an assessment of inflammation in prostate cancer in patients attending in surgery department at ESUT teaching hospital, Parklane, Enugu, Nigeria

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20205824 ◽

2020 ◽

Vol 9 (1) ◽

pp. 1

Author(s):

Clara N. Soronnadi ◽

Nancy C. Ibeh ◽

Francis O. Ugwene ◽

Grace I. Amilo ◽

Anthony J. Ede

Keyword(s):

Prostate Cancer ◽

Blood Cells ◽

Blood Count ◽

Age Groups ◽

Post Treatment ◽

Full Blood Count ◽

Treatment Results ◽

Lymphocyte Ratio ◽

Significant Difference ◽

Pre Treatment

Background: Full blood count (FBC) is a prerequisite investigation requested from all prostate cancer (PCa) patients pre and post treatment, poor parameter influences the outcome of cancers.Methods: Total subjects consisted of 84 male subjects between the ages 41 to >80 years. Longitudinal study was conducted. Controls and test samples were collected at diagnosis and at different stages of the treatment. Demographic information was obtained using a questionnaire. The data was analyzed using IBM statistical package for social sciences (SPSS) PC, version 20.0; SPSS Inc., Chicago, III., USA; the receiver operating characteristic curve (ROC) curve was obtained via neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR) and platelet-to-lymphocyte ratio (PLR) ratios cut-off determinations. Cox proportional-hazards regression analyses the prognostic factors (duration, ratios) and overall survival (diagnosis to death or last follow-up). A paired sample t-test compared test of significance in pre/post treatment results. The analysis of variance (ANOVA) and Tukey HSD post-hoc, test susceptibility within age groups was done.Results: Increased NLR and LMR were significantly associated with increased hazard ratio (HR) and OS at p<0.05 while PLR, no significant difference at P>0.05 in PCa. In complete blood count (CBC) and erythrocytic sedimentation rate (ESR), control and treatment period, all red blood cell (RBC) parameters showed a significant decrease at p<0.05 in treatment results compared to the pre-treatment results while total platelet (TPLT), total white blood cells (TWBC), NC, LC, ESR showed significant increase at p<0.05 in treatment results compared to pre-treatment results. Age group 41-50 years showed more susceptibility than other age groups with significant decrease at p<0.05 in NC, LC and increased MC.Conclusions: This study supports CBC and ESR biomarkers as a prognostic tool in early detection, treatment and monitoring of disease progression in these subjects.

Download Full-text