Harvard Medical School, Boston, MA, USA; Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.
Harvard Medical School, Boston, MA, USA; Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.
J Psychosom Res. 2018 Sep;112:9-12. doi: 10.1016/j.jpsychores.2018.06.006. Epub 2018 Jun 13.
Dropout from health behavior interventions in patients with heart disease is a major clinical issue that can impact recovery and prognosis. Positive psychology (PP)-based treatments have the potential to promote health behaviors, but predictors of PP intervention completion have not been examined in persons with heart disease.
Among 128 patients receiving a phone-based PP intervention to promote physical activity among acute coronary syndrome (ACS) patients, numerous baseline sociodemographic, medical, and psychological variables, along with self-reported pre/post improvements in happiness and optimism (on 0-10 Likert scales) associated with an initial PP exercise, were examined as potential predictors of intervention completion. Logistic and linear regression analyses were used to assess relationships between these predictors and (a) intervention completion (at least 4 of 8 sessions completed) and (b) number of total sessions completed.
No patient characteristic was associated with greater likelihood of completing the PP intervention. However, immediate pre-post change in optimism following the initial exercise was associated with intervention completion (odds ratio = 1.98; 95% confidence interval: 1.28-3.05; p = .002; mean post-exercise increase in optimism 0.79 [SD 1.52] in completers vs. mean optimism decrease of 0.59 [SD 1.42] in non-completers).
Pre-post change in optimism with a single PP activity predicted completion of an 8-week PP-based health behavior intervention in post-ACS patients. This information could be used clinically by having potential enrollees complete a single PP activity to assess intervention fit.
心脏病患者退出健康行为干预是一个主要的临床问题，可能会影响康复和预后。基于积极心理学（PP）的治疗方法有可能促进健康行为，但尚未在心脏病患者中研究过 PP 干预完成的预测因素。
在 128 名接受基于电话的 PP 干预以促进急性冠状动脉综合征（ACS）患者进行身体活动的患者中，研究了许多基线社会人口统计学、医学和心理变量，以及与初始 PP 运动相关的幸福感和乐观度的自我报告前后改善情况（在 0-10 级 Likert 量表上），这些变量被认为是干预完成的潜在预测因素。使用逻辑和线性回归分析评估了这些预测因素与（a）干预完成（至少完成 8 次中的 4 次）和（b）完成的总次数之间的关系。
没有患者特征与完成 PP 干预的可能性更大相关。然而，初始运动后乐观情绪的即时前后变化与干预完成相关（优势比=1.98；95%置信区间：1.28-3.05；p=0.002；完成者的平均后测乐观度增加 0.79 [SD 1.52]，未完成者的平均乐观度降低 0.59 [SD 1.42]）。
单次 PP 活动前后的乐观变化预测了 ACS 后患者 8 周基于 PP 的健康行为干预的完成。这一信息可以通过让潜在的参与者完成单次 PP 活动来评估干预的适应性，从而在临床上使用。
