فعالیت بدنی و نشانه های افسردگی در توانبخشی قلبی: اثرات طولانی مدت مداخله خودمدیریتی

Long-term effects of a self-management intervention on physical activity and depressive symptoms were studied in 198 men and women after cardiac rehabilitation in Germany. Participants were randomly assigned to either an intervention group or a standard-care control group. The intervention group received brief self-regulatory skills training that focused on exercise planning strategies. Four and 12 months later, physical exercise levels were half a standard deviation higher in the intervention group. Depressive symptoms 12 months after discharge were almost half a standard deviation lower in the intervention group than in the control group. Mediation analyses were performed to study the potential mechanism that accounted for the reduction in depression. Perceived attainment of exercise goals, but not physical exercise itself, emerged as a mediator between the intervention and the reduction of depressive symptoms. As such attainment of personal goals appears to be of particular importance for lowering depressive symptoms during health–behavior change. Thus, self-management strategies to help patients attain their goals should be part of rehabilitation programs.

This study was conducted to examine the effects of a brief intervention on physical exercise and depressive symptoms of cardiac patients in the year following rehabilitation treatment. A theory-guided treatment was designed to improve self-regulatory skills that are supposed to improve exercise maintenance and to lower depressive mood. Particular emphasis lies on the possible mechanisms that translate skills into emotions.

Randomization check Cell sizes of the two experimental groups turned out to be slightly unequal due to the randomization procedure. Participants with odd IDs were consecutively assigned to the intervention group, and those with even IDs to the control group. The IDs were specific for each consultant making initial contacts with patients. The initially unequal group sizes (control group: n=95n=95, intervention group: n=103n=103) were due to consultants seeing an uneven number of patients. A one-way ANOVA did not reveal any significant mean differences between the control group and the intervention group on T1 depressive symptoms, past physical exercise, T1 intentions, BMI, number of chronic diseases, amount of medications, or age. Likewise, using χ2 tests, no differences on the demographic variables (sex, marital status, years of education, employment status) were found, indicating that the randomization procedure was successful.