Magán Inés, Jurado-Barba Rosa, Moreno Guillermo, Ayán-Sanz María Paz, Izquierdo-Garcia Juan, Corradi Guido, Tello Rocio, Bueno Héctor
Facultad HM de Ciencias de la Salud de la Universidad Camilo José Cela - Villanueva de la Cañada, Madrid, Spain.
Instituto de Investigación Sanitaria HM Hospitales, Madrid, Spain.
Front Psychol. 2024 Nov 19;15:1420137. doi: 10.3389/fpsyg.2024.1420137. eCollection 2024.
Although psychological factors play a significant role in the onset and prognosis of acute coronary syndrome (ACS), psychological interventions (PIs) are rarely included in cardiac rehabilitation (CR) programs due to inconclusive evidence regarding specific intervention components and effect sizes. This study aimed to assess the efficacy of a PI based on cognitive-behavioral treatment (CBT) and positive psychology therapy (PPT) in improving psychological and clinical outcomes in patients with ACS.
This trial was an open-label randomized controlled trial that compared a combined CBT and PPT-based PI (the program) with a standard CR program (control group). We recruited 87 ACS patients, and psychological outcomes, functional capacity, biochemical and anthropometric measures, and clinical outcomes were assessed at baseline, 2 months, and 9 months after the ACS event.
The group showed significant improvements in depression, anger traits, anger-in, and anger control-out compared to the control group. Additionally, the intervention was associated with the improved maintenance of cognitive function, social support, and spiritual coping styles, while the control group showed deterioration in these areas. Patients experiencing severe ACS showed significant improvement in personal strength and meaning as a result of the intervention. However, no significant effects were observed on anxiety, anger-out, emotion regulation skills, dispositional optimism, other personal strengths, or quality of life. Both groups demonstrated similar improvements in functional capacity and clinical outcomes.
The study suggests that CBT and PPT-based PIs may offer additional benefits for ACS patients, particularly regarding their psychological health. Further larger trials are required to confirm these findings.
identifier, NCT05287061.
尽管心理因素在急性冠状动脉综合征（ACS）的发病和预后中起着重要作用，但由于关于特定干预成分和效应大小的证据尚无定论，心理干预（PI）很少被纳入心脏康复（CR）项目。本研究旨在评估基于认知行为疗法（CBT）和积极心理疗法（PPT）的PI对改善ACS患者心理和临床结局的疗效。
本试验为开放标签随机对照试验，将基于CBT和PPT的联合PI（该项目）与标准CR项目（对照组）进行比较。我们招募了87例ACS患者，并在ACS事件发生后的基线、2个月和9个月评估心理结局、功能能力、生化和人体测量指标以及临床结局。
与对照组相比，该组在抑郁、愤怒特质、内隐愤怒和愤怒控制外显方面有显著改善。此外，该干预与认知功能、社会支持和精神应对方式的维持改善相关，而对照组在这些方面则出现恶化。经历严重ACS的患者因该干预在个人力量和意义方面有显著改善。然而，在焦虑、外显愤怒、情绪调节技能、性格乐观、其他个人力量或生活质量方面未观察到显著影响。两组在功能能力和临床结局方面均有类似改善。
该研究表明，基于CBT和PPT的PI可能为ACS患者带来额外益处，特别是在心理健康方面。需要进一步的大型试验来证实这些发现。
标识符，NCT05287061。
