Integrating behavioral interventions into exercise rehabilitation for the well-being of patients with chronic heart failure

<b>Background:</b> In recent years, the integration of psychological interventions into the rehabilitation of patients with chronic heart failure (CHF) has become more apparent. The effectiveness of these interventions varies, with some having a positive impact while others showing no effect. It is unclear which psychological interventions are considered effective for patients with heart failure.<br /> <b>Aim:</b> We aimed to examine the impact of psychological interventions, encompassing psychoeducation, positive reinforcement, and stress management, on levels of stress, depression, and life satisfaction in patients with CHF.<br /> <b>Methods:</b> Thirty-six consecutive CHF patients in stable condition (mean age: 56 ± 10 years, left ventricle ejection fraction < 50%) were randomly assigned to the intervention group (IG) (n = 18) or the control group (CG) (n = 18). All participants engaged in a structured rehabilitation program three times a week for a duration of 12 weeks. The IG received additional emotional support through 12 sessions of psychoeducation, stress resilience techniques, and positive behavior reinforcement. Measurements were conducted both pre- and post-intervention, with values expressed as mean and standard deviation.<br /> <b>Results:</b> Following 12 weeks of rehabilitation, the IG demonstrated a substantial reduction in depression rates (from 3.4 [4.0] to 1.6 [2.4], p < 0.01), in contrast to the CG (from 3.6 [3.4] to 4.0 [3.7], p = 0.32). Stress levels were significantly diminished (p < 0.01) in both the IG (from 14.3 [8.6] to 9.1 [7.4]) and the CG (from 13.2 [9.8] to 8.6 [5.9]). Moreover, life satisfaction markedly increased in the IG (from 23.8 [5.2] to 30.8 [3.5], p < 0.01), while it decreased in the CG (from 26.0 [6.91] to 20.2 [6.5], p < 0.01). Noteworthy between-group differences were observed in depression rates and life satisfaction (p < 0.01).<br /> <b>Conclusions:</b> Psychological interventions, alongside a structured exercise rehabilitation program, featuring psychoeducation, stress management techniques, and positive reinforcement, emerges as a potent strategy for alleviating depressive symptoms and enhancing the mental well-being of patients. This underscores the potential of a comprehensive approach that seamlessly integrates both physical and psychological interventions.