Tunheim Kristoffer, Papageorgiou Costas, Lie Hanne C, Munkhaugen John, Dammen Toril
Department of Medicine, Drammen Hospital, Vestre Viken HF Postboks 800, Drammen, 3004, Norway.
Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
BMC Psychiatry. 2025 Jun 3;25(1):573. doi: 10.1186/s12888-025-07027-4.
Clinically significant anxiety and depression symptoms are common in patients with coronary heart disease (CHD) and associated with a range of negative outcomes. Preliminary evidence suggests that the attention training technique (ATT), a component of metacognitive therapy (MCT), delivered in a group format, is feasible and potentially effective in reducing symptoms of anxiety and depression in these patients. Patients' experiences of treatment including facilitators and barriers are useful in order to further develop effective intervention. We are not aware of any previous qualitative studies conducted on ATT in patients with CHD. Our study aimed to assess the treatment experiences in these patients.
Patients (N = 10) with CHD and significant symptoms of anxiety and/or depression, who participated in a randomized controlled trial of the effectiveness of ATT delivered in a group format, were recruited to in-depth, individual interviews three months after treatment completion. The interviews were recorded, transcribed and analysed according to the principles of thematic analysis.
Nine males and one female participated, with a mean age of 54.3 (range 45-63) years. Mean time since cardiac event was 54.2 months. We identified two main themes; non-specific ATT treatment factors and group ATT-specific treatment factors. Furthermore, non-specific ATT treatment factors included subthemes relating to individual and group factors. These subthemes encompassed the (relational aspects such as the) interaction between the group patients, interaction between the patients and the therapist, and the therapist's delivery of the group ATT. Second, specific ATT treatment factors included subthemes concerning understanding and making sense of the technique and treatment, changes in relation to thoughts and thinking, and group format as a facilitator of ATT treatment.
Group ATT was perceived as helpful among outpatients with CHD in terms of symptom relief. Both general and ATT specific factors were regarded important, and the patients seemed to understand ATT in a way that is consistent with the rationale of ATT treatment. All patients emphasized the importance of the group format.
The study was approved by the Regional Committee of Ethics (REK) South East Norway (REK 52002) and by the data protection officer at Drammen Hospital (20/04048-1/005). The study is registered at clinicaltrials.gov (Identifier NCT05621408).
临床上显著的焦虑和抑郁症状在冠心病（CHD）患者中很常见，并与一系列负面结果相关。初步证据表明，注意力训练技术（ATT）作为元认知疗法（MCT）的一个组成部分，以小组形式进行，在减轻这些患者的焦虑和抑郁症状方面是可行的且可能有效。了解患者的治疗体验，包括促进因素和障碍，对于进一步开发有效的干预措施很有帮助。我们不知道之前是否有针对冠心病患者进行的关于ATT的定性研究。我们的研究旨在评估这些患者的治疗体验。
招募了10名患有冠心病且有显著焦虑和/或抑郁症状的患者，他们参与了一项关于小组形式的ATT有效性的随机对照试验，在治疗完成三个月后接受深入的个人访谈。访谈进行录音、转录，并根据主题分析原则进行分析。
9名男性和1名女性参与，平均年龄为54.3岁（范围45 - 63岁）。自心脏事件发生后的平均时间为54.2个月。我们确定了两个主要主题；非特异性ATT治疗因素和小组ATT特异性治疗因素。此外，非特异性ATT治疗因素包括与个体和小组因素相关的子主题。这些子主题包括（诸如关系方面的）小组患者之间的互动、患者与治疗师之间的互动以及治疗师实施小组ATT的情况。其次，特异性ATT治疗因素包括与理解和领会该技术及治疗、思维和思考方式的改变以及小组形式作为ATT治疗促进因素相关的子主题。
对于冠心病门诊患者而言，小组ATT在缓解症状方面被认为是有帮助的。一般因素和ATT特异性因素都被视为重要因素，并且患者对ATT的理解方式似乎与ATT治疗的基本原理一致。所有患者都强调了小组形式的重要性。
该研究获得了挪威东南部地区伦理委员会（REK）（REK 52002）以及德拉门医院数据保护官员（20/04048 - 1/005）的批准。该研究已在clinicaltrials.gov注册（标识符NCT05621408）。
