ARYA Atherosclerosis Journal

The effectiveness of dialectical behavior therapy on adherence to treatment and self-caring behavior in patients with coronary heart disease

Document Type : Original Article(s)

Authors

Fatemeh Tavakoli 1
Hamid Kazemi-Zahrani 2
Masoumeh Sadeghi 3

1 Department of Clinical Psychology, Khomeinishahr Branch, Islamic Azad University, Khomeinishahr, Isfahan, Iran

2 Assistant Professor, Department of Psychology, Payame Noor University, Tehran, Iran

3 Professor, Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran

https://doi.org/10.22122/arya.v15i6.1733
Abstract
BACKGROUND: 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).METHODS: 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.RESULTS: 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.CONCLUSION: 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. 

Keywords

Coronary Disease
Dialectical Behavior Therapy
Treatment Adherence
Self-Care
  1. Roger VL, Go AS, Lloyd-Jones DM, Benjamin EJ, Berry JD, Borden WB, et al. Executive summary: Heart disease and stroke statistics-2012 update: A report from the American Heart Association. Circulation 2012; 125(1): 188-97.
  2. Sloan DM, Kring AM. Measuring changes in emotion during psychotherapy: Conceptual and methodological issues. Clin Psychol Sci Pract 2007; 14(4): 307-22.
  3. Venner GH, Seelbinder JS. Team management of congestive heart failure across the continuum. J Cardiovasc Nurs 1996; 10(2): 71-84.
  4. Barefoot JC, Brummett BH, Williams RB, Siegler IC, Helms MJ, Boyle SH, et al. Recovery expectations and long-term prognosis of patients with coronary heart disease. Arch Intern Med 2011; 171(10): 929-35.
  5. Monirpour N, Bakhshi S, Raeisi Z, Sadeghian S, Nourbaha A. Relationship between disease perception, coping strategies, and social support with adherence to treatment among patients with cardiovascular diseases. Daneshvar Med 2013; 21(5): 1-10. [In Persian].
  6. Toljamo M, Hentinen M. Adherence to self-care and social support. J Clin Nurs 2001; 10(5): 618-27.
  7. Khodadadi A, Sayadi A, Smaeli H. Evolution of knowledge of the principles of self care in acute coronary syndrome patients admitted to Aliebn abitaleb Rafsanjan university hospital during 2009. Community Health Journal 2011; 5(1): 8-16. [In Persian].
  8. Schreurs KM, Colland VT, Kuijer RG, de Ridder DT, van Elderen T. Development, content, and process evaluation of a short self-management intervention in patients with chronic diseases requiring self-care behaviours. Patient Educ Couns 2003; 51(2): 133-41.
  9. Mast C. Personal and environmental factors affecting self-care behaviors of patients with heart failure [MSc Thesis]. Muncie, Indiana: Ball State University; 2008.
  10. Gonzalez B, Lupon J, Herreros J, Urrutia A, Altimir S, Coll R, et al. Patient's education by nurse: What we really do achieve? Eur J Cardiovasc Nurs 2005; 4(2): 107-11.
  11. Asmand P, Mami S, Valizadeh R. The effectiveness of dialectical behavior therapy and rational emotive behavior therapy in irrational believes treatment among young male prisoners who have antisocial personality disorder in Ilam Prison. Int J Health Syst Disaster Manage 2015; 3(2): 68-73.
  12. Delavar A. Educational and psychological research. Tehran, Iran: Virayesh Publications; 2017. [In Persian].
  13. Morisky DE, Ang A, Krousel-Wood M, Ward HJ. Predictive validity of a medication adherence measure in an outpatient setting. J Clin Hypertens (Greenwich) 2008; 10(5): 348-54.
  14. Kooshyar H, Shoorvazi M, Dalir Z, Hosseini M. Health literacy and its relationship with medical adherence and health-related quality of life in diabetic community-residing elderly. J Mazandaran Univ Med Sci 2014; 23(1): 134-43. [In Persian].
  15. Linehan M. Cognitive-behavioral treatment of borderline personality disorder. New York, NY: Guilford Press; 1993.
  16. McKAY M, Wood JC, Brantley J. The dialectical behavior therapy skills workbook: Practical DBT exercises for Learning Mindfulness, Interpersonal Effectiveness, Emotion Regulation and Distress Tolerance. Oakland, CA: New Harbinger Publications; 2007.
  17. Sheets MG. Out-of-Control: A dialectical behavior therapy (DBT)-cognitive-behavioral therapy (CBT) workbook for getting control of our emotions and emotion-driven behavior. Trans. Izadi S, Ghiyasi M. Tehran, Iran: Arjmand Publications; 2009. [In Persian].
  18. Vaughan Dickson V, Lee CS, Yehle KS, Mola A, Faulkner KM, Riegel B. Psychometric testing of the self-care of coronary heart disease inventory (SC-CHDI). Res Nurs Health 2017; 40(1): 15-22.
  19. Shikany JM, Safford MM, Bryan J, Newby PK, Richman JS, Durant RW, et al. Adherence to various dietary patterns and risk of recurrent coronary heart disease and mortality in the reasons for geographic and racial differences in stroke (REGARDS) Study. Circulation 2017; 135(suppl_1): A13.
  20. Iakovleva MV. Adherence to treatment after coronary bypass surgery: Psychological aspects. Revista Iberoamericana de Psicologia y Salud 2016; 7(1): 9-14 [In Spainish].
  21. Mosleh SM, Almalik MM. Illness perception and adherence to healthy behaviour in Jordanian coronary heart disease patients. Eur J Cardiovasc Nurs 2016; 15(4): 223-30.
  22. Rosenzweig S, Greeson JM, Reibel DK, Green JS, Jasser SA, Beasley D. Mindfulness-based stress reduction for chronic pain conditions: Variation in treatment outcomes and role of home meditation practice. J Psychosom Res 2010; 68(1): 29-36.
  23. Merkes M. Mindfulness-based stress reduction for people with chronic diseases. Aust J Prim Health 2010; 16(3): 200-10.
  24. Sherwood A, Smith PJ, Hinderliter AL, Georgiades A, Blumenthal JA. Effects of exercise and stress management training on nighttime blood pressure dipping in patients with coronary heart disease: A randomized, controlled trial. Am Heart J 2017; 183: 85-90.
  25. Lukkarinen H, Hentinen M. Self-care agency and factors related to this agency among patients with coronary heart disease. Int J Nurs Stud 1997; 34(4): 295-304.
ARYA Atherosclerosis Journal
Volume 15, Issue 6 - Serial Number 6
November and December 2019
Pages 281-287

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