Improve Adherence to Treatment and Self-Care of Coronary Heart Disease Patients with Mindfulness
By John M. de Castro, Ph.D.
“Not only can meditation improve how your heart functions, but a regular practice can enhance your outlook on life and motivate you to maintain many heart-healthy behaviors, like following a proper diet, getting adequate sleep, and keeping up regular exercise,” – Dr. John Denninger
Cardiovascular disease is the number one killer. A myriad of treatments has been developed including a variety of surgical procedures and medications. In addition, lifestyle changes have proved to be effective including quitting smoking, weight reduction, improved diet, physical activity, and reducing stresses. Unfortunately, for a variety of reasons, 60% of cardiovascular disease patients decline engaging in these lifestyle changes, making these patients at high risk for another attack.
Contemplative practices have been shown to be safe and effective alternative treatments for cardiovascular disease. Practices such as meditation, tai chi, and yoga, have been shown to be helpful for heart health and to reduce the physiological and psychological responses to stress. They have also been shown to be effective in maintaining cardiovascular health and the treatment of cardiovascular disease. Dialectical Behavior Therapy (DBT) is a mindfulness-based therapeutic technique that produces behavior change by focusing on changing the thoughts and emotions that precede problem behaviors, as well as by solving the problems faced by individuals that contribute to problematic thoughts, feelings and behaviors. In DBT five core skills are practiced; mindfulness, distress tolerance, emotion regulation, the middle path, and interpersonal effectiveness.
It makes sense, then, to study the effectiveness of Dialectical Behavior Therapy (DBT) for the treatment of patients with Coronary Heart Disease. In today’s Research News article “The effectiveness of dialectical behavior therapy on adherence to treatment and self-caring behavior in patients with coronary heart disease.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7073803/) Tavakoli and colleagues recruited patients with coronary heart disease. They continued to receive treatment as usual and were randomly assigned to receive either no additional treatment or an 8 weekly 2-hour session of Dialectical Behavior Therapy (DBT). They were measured before and after training for medication adherence and self-care for coronary heart disease.
They found that in comparison to baseline and the control group that the patients who received Dialectical Behavior Therapy (DBT) had significantly improved medication adherence and self-care for coronary heart disease. These effects of DBT would predict favorable outcomes. After DBT the patients take their medication more reliably and they better maintain and manage their own care and have greater confidence in their ability to care for themselves. These improvements to the patients’ behavior should lead to better recovery from coronary heart disease and better overall health.
So, improve adherence to treatment and self-care of coronary heart disease patients with mindfulness.
“this practice may be clinically useful in the secondary prevention of cardiovascular disease [the prevention of further heart or stroke events for people who already have the condition].” – Heart Matters
CMCS – Center for Mindfulness and Contemplative Studies
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Tavakoli, F., Kazemi-Zahrani, H., & Sadeghi, M. (2019). The effectiveness of dialectical behavior therapy on adherence to treatment and self-caring behavior in patients with coronary heart disease. ARYA atherosclerosis, 15(6), 281–287. https://doi.org/10.22122/arya.v15i6.1733
The aim of this study was to investigate the effectiveness of dialectical behavior therapy (DBT) on adherence to treatment and self-caring behavior in patients with coronary heart disease (CHD).
This was an experimental study based on control and experimental groups with pre-test and post-test. 32 male and female patients with CHD having at least high school diploma, referring to Isfahan cardiovascular research institute, Isfahan, Iran, were selected and placed randomly in two groups of control and experimental. Pre-test stage was done for both two groups by 8-item Morisky Medication Adherence Scale (MMAS-8) and Self-Care of Coronary Heart Disease Inventory (SC-CHDI). The experimental group was placed under the intervention of DBT for 8 sessions of 2 hours (once a week). Afterwards, the post-test was done for both groups.
It was shown by analyzing results from t-test that adherence to treatment and self-care behavior significantly increased in experimental group comparing to control group [(1.81 ± 0.75 vs. 5.19 ± 1.22, P < 0.001) and (72.50 ± 4.38 vs. 55.50 ± 7.42, P < 0.001), respectively]. Also results showed that self-caring and adherence to treatment significantly increased after being adjusted for baseline measurement (P < 0.001). The findings showed that DBT had effect on adherence to treatment and self-caring behavior of patients with CHD.
On the basis of results, it could be said that DBT intervention can have positive impact on adherence to treatment and self-caring behavior of patients with CHD.