title: Patients attachment patterns and response to a program for alleviating cardiovascular risk factors: a 1-year follow-up of patients in a patient education program.
abstract: This study was a 1-year follow-up of 295 consecutive patients at a patient education centre and assessed how attachment style influenced the outcome of the patient education program devised for individuals with multiple risk factors for cardiovascular disease. The program consisted of a 4-week residential program course, followed by a 4-day follow-up course a year later. In our cohort study, the 295 consecutive patients (mean age = 52years, S.D.=9.2) with multiple risk factors for cardiovascular disease, showed an initial overall reduction of 4.4 kg in weight (P=0.0001) and a reduction of 17/11 mm in systolic and diastolic blood pressure (P=0.0001 and 0.0001). The weight remained essentially the same at the follow-up 1 year later, whereas blood pressure tended to return to previous level. The attachment style was determined by means of a questionnaire: 87% were classified as 'secure', 9% 'avoidant' and 5% as 'ambivalent'. After 4 weeks, the ambivalent category had reduced weight (body mass index (BMI)) more than the secure group (P=0.04). At the 1-year follow-up, the avoidant category showed a more pronounced reduction in diastolic blood pressure than the other groups (P=0.001). Thus, it seems as if attachment style does have some influence on outcome. Patient education should take advantage of knowing patients' attachment style.
authors.affiliation: Department of Community Medicine and Rehabilitation, Social Medicine, Umeå University, Umeå, Sweden. gunnar.kaati@socmed.umu.se
authors.forename: G
authors.initials: G
authors.lastname: Kaati
authors.forename: M
authors.initials: M
authors.lastname: Vester
authors.forename: M
authors.initials: M
authors.lastname: Sjöström
authors.forename: L O
authors.initials: LO
authors.lastname: Bygren
mesh_terms: D002318:Cardiovascular Diseases / Q000517:prevention & control*; D005500:Follow-Up Studies; D015438:Health Behavior; D006801:Humans; D009769:Object Attachment; D010353:Patient Education as Topic; D012307:Risk Factors; D013548:Sweden