Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
Melbourne School of Psychological Sciences, University of Melbourne, Victoria, Australia.
Gen Hosp Psychiatry. 2019 Nov-Dec;61:125-129. doi: 10.1016/j.genhosppsych.2019.06.001. Epub 2019 Jun 4.
Adherence to health behaviors following an acute coronary syndrome (ACS) is strongly associated with superior prognosis. Both optimism and positive affect may play important roles in such adherence. However, the relationship between changes in these constructs in the context of positive psychology interventions (PPIs) and adherence to health behaviors is not fully understood. Accordingly, we aimed to examine these relationships among a cohort of post-ACS patients receiving a PPI.
Post-ACS participants who received a PPI during a factorial trial (N = 128) completed self-report measures of positive affect and optimism, along with the Medical Outcomes Study Specific Adherence Scale items for diet, physical activity, and medication adherence, over 16 weeks. The baseline and longitudinal effects of positive affect and optimism-representing changes in those constructs-on adherence were analyzed using mixed effects regression models.
Positive affect, but not optimism, was longitudinally associated with greater overall adherence to health behaviors (positive affect: β = 0.057, p = .006; optimism: β = 0.032, p = .36), with the effect driven by physical activity adherence (positive affect: β = 0.040, p = .004; optimism: β = 0.005, p = .83).
Changes in positive affect may be more strongly associated with post-ACS adherence than optimism; this could have important implications for the development of PPIs to promote adherence.
急性冠状动脉综合征（ACS）后坚持健康行为与预后改善密切相关。乐观和积极情绪可能在这种坚持中发挥重要作用。然而，积极心理干预（PPIs）背景下这些结构变化与健康行为依从性之间的关系尚不完全清楚。因此，我们旨在检查接受 PPI 的 ACS 后患者队列中的这些关系。
在一项析因试验中接受 PPI 的 ACS 后参与者（N=128）在 16 周内完成了积极情绪和乐观的自我报告测量，以及饮食、身体活动和药物依从性的医疗结局研究特定依从性量表项目。使用混合效应回归模型分析积极情绪和乐观（代表这些结构的变化）对依从性的基线和纵向影响。
积极情绪，但不是乐观，与健康行为的整体依从性呈纵向相关（积极情绪：β=0.057，p=0.006；乐观：β=0.032，p=0.36），这种影响由身体活动依从性驱动（积极情绪：β=0.040，p=0.004；乐观：β=0.005，p=0.83）。
与乐观相比，积极情绪的变化可能与 ACS 后依从性的相关性更强；这对开发促进依从性的 PPI 具有重要意义。
