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Internet-based CBT in patients with non-cardiac chest pain - design of a randomized controlled pilot study
Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Cardiology in Linköping.ORCID iD: 0000-0002-4259-3671
Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Cardiology in Linköping.ORCID iD: 0000-0001-7431-2873
Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
2014 (English)Conference paper, Poster (with or without abstract) (Other academic)
Abstract [en]

Introduction: The majority of the patients seeking medical care due to chest pain are admitted for in-hospital cardiac "rule out" observation, but only one third of all patients have ischemic heart disease. More than half of these patients are diagnosed as "non-cardiac chest pain" (NCCP). Patients with NCCP utilize a substantial amount of healthcare resources, and contribute to high costs for society. Patients with NCCP may be suffering from pain-related fear and inappropriate health beliefs leading to avoidance of physical activities that they think could be harmful to their hearts. We hypothesize that these patients will gain from evaluating the accuracy and usefulness of their thoughts, and shifting their cognitive appraisals from unhealthy and maladaptive to constructive and adaptive.

Purpose: To test the feasibility and effectiveness of an intervention based on CBT supporting patients to handle chest pain and related emotions, reactions and thoughts.

Methods: A total of twenty patients will be recruited to this randomized controlled pilot study planned to start in April 2014. Eligible for the study will be persons over the age of 18 who during the last 6 months had sought care at least twice due to non-cardiac chest pain, and who screened positive for bodily sensations and/or avoidance of physical activity. The intervention will be a guided 4 weeks internet-based CBT programme with the following content: •Information to increase patients’ knowledge of chest pain and its impact on daily life. •Reflection upon the strategies patients use and how these can change to facilitate management of chest pain, and related emotions, reactions and thoughts. •Tailored moderate physical activity, 30 minutes per day, to get reassured that the heart tolerates physical activity and to decrease pain-related fear. •Relaxation exercise, 15 minutes per day, that can be used to cope with general stress and if appropriate to use in relation to chest pain. The control group will receive "care as usual".

Outcomes: The primary outcome will be "fear of bodily sensations" measured with the Bodily sensations questionnaire. The secondary outcomes will be "illness perception, pain, anxiety, depressive symptoms, quality of life, healthcare utilization and costs".

Study significance: This study will reveal if the intervention is feasible and what effects it has on how patients perceive and handle chest pain. In case of positive outcomes, the study participants as well as the patient group will benefit in terms of better health. In the long term, society will also benefit from a reduction in healthcare utilization and costs.

Place, publisher, year, edition, pages
2014.
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-108722OAI: oai:DiVA.org:liu-108722DiVA: diva2:731612
Conference
EuroHeartCare 2014, April 4-5, 2014, Stavanger, Norway
Available from: 2014-07-02 Created: 2014-07-02 Last updated: 2015-05-07

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Mourad, GhassanStrömberg, AnnaJohansson, PeterJaarsma, Tiny

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Mourad, GhassanStrömberg, AnnaJohansson, PeterJaarsma, Tiny
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Division of Health, Activity and CareFaculty of Health SciencesDivision of Nursing ScienceDepartment of Cardiology in LinköpingDepartment of Medical and Health Sciences
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