Effectiveness of Mindfulness and Positive Strengthening mHealth Interventions for the Promotion of Subjective Emotional Wellbeing and Management of Self-Efficacy for Chronic Cardiac Diseases
Abstract
:1. Introduction
1.1. Subjective Emotional Wellbeing and Management Self-Efficacy for Cardiovascular Health
1.2. Mindfulness Interventions
1.3. Positive Strengthening Interventions
1.4. Objectives and Hypotheses
2. Materials and Methods
2.1. Participants and Procedure
2.2. Interventions
2.2.1. In-Person Intervention
2.2.2. mHealth Intervention
- Mindfulness mHealth intervention. The mindfulness intervention consisted of formal and informal mindfulness-based exercises (e.g., breathing awareness, body scan, exploration through the senses). We adapted a mindfulness-based stress reduction program [47] for instruction by messaging with the specific objective of full attention every day (see Supplemental File S1). The practice based on breathing awareness was carried out for 10 min. The goal was to develop awareness in cardiac patients through this approach based on contact with the present moment and full attention.
- Positive strengthening mHealth intervention. The program of activities was adapted by our research team from Seligman’s approach [7] (see Supplemental File S1). For this intervention, activities were proposed for a positive assessment of the main vital areas of the participant’s life (personal, family, social, and daily life). The objective of the program was to reinforce the importance of focusing on the good things that happen to us each day, combined with gratitude exercises and assessment of personal achievements from the perspective of positive psychology.
2.2.3. TAU Group
2.3. Measures
2.3.1. Positive and Negative Affect
2.3.2. Cardiovascular Management Self-Efficacy Scale (CMSES)
2.3.3. Self-Efficacy for Managing Chronic Disease Scale (SEMCD)
2.3.4. Anxiety and Depression
2.3.5. Engagement and Satisfaction
2.4. Data Analyses
3. Results
4. Discussion
4.1. Strengths
4.2. Limitations and Future Research
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Total (n = 93) | Mindfulness Group (n = 32) | Positive Strengthening Group (n = 32) | TAU Group (n = 29) | Statistical Significance | |
---|---|---|---|---|---|
Age (M, SD) | 63.9 (10.9) | 64.8 (10.1) | 61 (10.3) | 66.2 (12.1) | (F(2,90)= 1.87, ns) |
Gender, n (%) | (X2 = 4.59, gl 2, ns) | ||||
Male | 76 (82%) | 28 | 28 | 20 | |
Female | 17 (18%) | 4 | 4 | 9 | |
Marital status n (%) | (X2 = 17, df 10, ns) | ||||
Single | 6 (7%) | 4 | 1 | 1 | |
Single with couple | 2 (2%) | 2 | 0 | 0 | |
Cohabiting partner | 1 (1%) | 1 | 0 | 0 | |
Married | 79(85%) | 24 | 31 | 24 | |
Separated | 2 (2%) | 1 | 0 | 1 | |
Widowed | 3 (3%) | 0 | 0 | 3 | |
Employment status n (%) | (X2 = 5.4, gl 8, ns) | ||||
Retired | 60 (65%) | 21 | 17 | 22 | |
Part-time work | 1 (1%) | 0 | 1 | 0 | |
Full-time work | 22(24%) | 7 | 10 | 5 | |
Unemployed | 7 (7%) | 3 | 3 | 1 | |
Home care | 3 (3%) | 1 | 1 | 1 | |
Educational level n (%) | (X2 = 19.28, gl 8, ns) | ||||
Elementary school | 68 (73%) | 22 | 23 | 23 | |
Middle school | 6 (7%) | 0 | 5 | 1 | |
High school | 11 (12%) | 6 | 3 | 2 | |
University | 8 (9%) | 4 | 1 | 3 | |
Economic level | (X2 = 14.1, gl 6, ns) | ||||
<22,000 € | 78 (84%) | 25 | 26 | 27 | |
22,000–43,000 € | 13 (14%) | 6 | 5 | 2 | |
>43,000 € | 2 (2%) | 1 | 1 | 0 | |
Age onset CVD (M, SD) | 60 (11.5) | 61.1 (10.8) | 54.1 (13.24) | 63.0 (11.8) | (F(2,90) = 4.63, p < 0.01) |
Time with CVD (M, SD) | 3.82 (6.04) | 3.81 (5.10) | 5.41 (7.77) | 2.07 (4.27) | (F(2,39) = 0.097, ns) |
Type of CVD n (%) | |||||
Angina pectoris | 31 (33%) | 12 | 13 | 6 | (X2= 3.1, gl 2, ns) |
Myocardial infarction | 42 (45%) | 11 | 16 | 15 | (X2= 2.31, gl 2, ns) |
Hearth failure | 8 (9%) | 3 | 1 | 4 | (X2= 2.24, gl 2, ns) |
Arrhythmia | 9 (10%) | 3 | 3 | 3 | (X2= 0.02, gl 2, ns) |
Other | 19 (20%) | 9 | 6 | 4 | (X2= 2, gl 2, ns) |
More than one CVD n (%) | 16 (17.2%) | 6 | 7 | 3 | |
Level of limitation of ADL n (%) | |||||
Level 1 | 43 | 19 | 14 | 10 | (X2= 3.9, gl 2, ns) |
Level 2 | 27 | 8 | 9 | 10 | (X2 = 0.68, gl 8, ns) |
Level 3 | 19 | 3 | 7 | 9 | (X2 = 4.45, gl 2, ns) |
Level 4 | 4 | 2 | 2 | 0 | (X2 = 1.89, gl 2, ns) |
Variable | Mean Square | F | df | Error df | p | ηp2 | Power |
---|---|---|---|---|---|---|---|
Positive affect | |||||||
Time | 6.22 | 8.39 | 2.85 | 250.78 | <0.001 | 0.09 | 0.99 |
Time × anxiety | 0.38 | 0.52 | 2.85 | 250.78 | 0.661 | 0.01 | 0.15 |
Time × depression | 1.26 | 1.70 | 2.85 | 250.78 | 0.171 | 0.02 | 0.43 |
Time × condition | 8.56 | 5.77 | 5.70 | 250.78 | <0.001 | 0.12 | 1.00 |
Error | 65.29 | ||||||
Negative affect | |||||||
Time | 4.25 | 10.83 | 2.69 | 236.48 | <0.001 | 0.11 | 1.00 |
Time × anxiety | 5.13 | 13.08 | 2.69 | 236.48 | <0.001 | 0.13 | 1.00 |
Time × depression | 0.41 | 1.04 | 2.69 | 236.48 | 0.370 | 0.01 | 0.27 |
Time × condition | 4.47 | 5.69 | 5.38 | 236.48 | <0.001 | 0.12 | 1.00 |
Error | 34.53 | ||||||
CMSE | |||||||
Time | 3.73 | 10.78 | 2.12 | 185.39 | <0.001 | 0.11 | 0.99 |
Time × anxiety | 0.21 | 0.61 | 2.12 | 185.39 | 0.552 | 0.01 | 0.15 |
Time × depression | 1.09 | 3.16 | 2.12 | 185.39 | 0.042 | 0.04 | 0.62 |
Time × condition | 4.58 | 6.62 | 4.21 | 185.39 | <0.001 | 0.13 | 0.99 |
Error | 30.46 | ||||||
SEMCD | |||||||
Time | 20.78 | 7.18 | 2.98 | 262.35 | <0.001 | 0.08 | 0.98 |
Time × anxiety | 3.70 | 1.28 | 2.98 | 262.35 | 0.281 | 0.01 | 0.34 |
Time × depression | 8.74 | 3.02 | 2.98 | 262.35 | 0.031 | 0.03 | 0.71 |
Time × condition | 14.05 | 2.43 | 5.96 | 262.35 | 0.027 | 0.05 | 0.82 |
Error | 254.55 |
Mindfulness M (SD) | Positive Strengthening M (SD) | ANOVA F (1,62); p | |
---|---|---|---|
Post-test 1 | |||
Engagement | 4.54 (0.66) | 4.33 (0.85) | 1.29, 0.26 |
General satisfaction | 9.09 (0.92) | 8.73 (1.44) | 1.51, 0.22 |
Post-test 2 | |||
Engagement | 3.67 (1.02) | 4.03 (0.86) | 2.42, 0.13 |
General satisfaction | 8.85 (1.44) | 8.97 (1.03) | 0.15, 0.70 |
Post-test 3 | |||
Engagement | 3.88 (0.98) | 3.75 (0.88) | 0.29, 0.59 |
General satisfaction | 9.31 (1.18) | 9.00 (1.02) | 1.29, 0.26 |
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Tabernero, C.; Gutiérrez-Domingo, T.; Steca, P.; Castillo-Mayén, R.; Cuadrado, E.; Rubio, S.J.; Farhane-Medina, N.Z.; Luque, B. Effectiveness of Mindfulness and Positive Strengthening mHealth Interventions for the Promotion of Subjective Emotional Wellbeing and Management of Self-Efficacy for Chronic Cardiac Diseases. J. Pers. Med. 2022, 12, 1953. https://doi.org/10.3390/jpm12121953
Tabernero C, Gutiérrez-Domingo T, Steca P, Castillo-Mayén R, Cuadrado E, Rubio SJ, Farhane-Medina NZ, Luque B. Effectiveness of Mindfulness and Positive Strengthening mHealth Interventions for the Promotion of Subjective Emotional Wellbeing and Management of Self-Efficacy for Chronic Cardiac Diseases. Journal of Personalized Medicine. 2022; 12(12):1953. https://doi.org/10.3390/jpm12121953
Chicago/Turabian StyleTabernero, Carmen, Tamara Gutiérrez-Domingo, Patrizia Steca, Rosario Castillo-Mayén, Esther Cuadrado, Sebastián J. Rubio, Naima Z. Farhane-Medina, and Bárbara Luque. 2022. "Effectiveness of Mindfulness and Positive Strengthening mHealth Interventions for the Promotion of Subjective Emotional Wellbeing and Management of Self-Efficacy for Chronic Cardiac Diseases" Journal of Personalized Medicine 12, no. 12: 1953. https://doi.org/10.3390/jpm12121953