title: Evaluation of a Coping Effectiveness Training intervention in patients with chronic heart failure - a randomized controlled trial.
abstract: Impaired emotional well-being has detrimental effects on health outcomes in patients with chronic heart failure (CHF).
  
  
  
  To evaluate a nurse-led Coping Effectiveness Training (CET) group intervention for patients with CHF. It was hypothesized that CET would increase emotional well-being (primary outcome) and health-related quality (HRQoL) of life and improve clinical outcomes. Furthermore, changes in appraisal and coping as mediators of the intervention effect were examined.
  
  
  
  Participants were randomized to either control group (n=51) receiving standard health care or CET intervention group (n=52). Self-assessments of positive affect, negative affect, depression, anxiety, HRQoL, illness perception, coping strategies and social support were performed pre- and post-intervention and after six weeks, six months and 12 months. Time to death and hospitalizations were measured during the entire follow-up (median 35 months, interquartile range 11 months).
  
  
  
  No significant improvements for emotional well-being and HRQoL in the intervention group compared with the control group were found. After excluding patients with clinical anxiety and depression at baseline the intervention group had significantly lower negative affect (p = 0.022). There were no significant differences regarding cardiovascular events between the groups. The intervention group had greater sense of control over their illness in the short-term (p = 0.036).
  
  
  
  CET intervention was found to increase sense of control over the illness in the short term. Psychosocial support programmes, like CET, for patients with CHF is currently lacking evidence for implementing in clinical practice. However, the results provide a basis for future studies with a modified CET intervention design and increased study size.
authors.affiliation: The Swedish Red Cross University College, Stockholm, Sweden catarina.nahlen.bose@rkh.se.|Department of Clinical Sciences Danderyd Hospital AB, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Catarina
authors.initials: C
authors.lastname: Nahlén Bose
authors.affiliation: Department of Clinical Sciences Danderyd Hospital AB, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Hans
authors.initials: H
authors.lastname: Persson
authors.affiliation: The Swedish Red Cross University College, Stockholm, Sweden.|Department of Clinical Sciences Danderyd Hospital AB, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Gunilla
authors.initials: G
authors.lastname: Björling
authors.affiliation: Public Healthcare Services Committee Administration, Stockholm County Council, Sweden.|Department of Learning, Informatics, Management and Ethics, Medical Management Centre, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Gunnar
authors.initials: G
authors.lastname: Ljunggren
authors.affiliation: Mälardalen University, Academy of Health, Care and Social Welfare, Eskilstuna/Västerås, Sweden.
authors.forename: Magnus L
authors.initials: ML
authors.lastname: Elfström
authors.affiliation: The Swedish Red Cross University College, Stockholm, Sweden.|Department of Clinical Neuroscience, Division of Insurance Medicine, Administration, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Fredrik
authors.initials: F
authors.lastname: Saboonchi
mesh_terms: D000223:Adaptation, Psychological; D001007:Anxiety; D002908:Chronic Disease; D003863:Depression; D006333:Heart Failure / Q000523:psychology*; D006801:Humans; D009732:Nursing Care; D010353:Patient Education as Topic
keywords: Heart failure; affect; follow-up; intervention; randomized controlled trial; sense of control