Impact of the Relaxation Response Resiliency Program on Patients With Atrial Fibrillation
- Conditions
- Atrial FibrillationStressQuality of LifeHostilityAnxietyDepression
- Interventions
- Behavioral: Relaxation Response Resiliency Program
- Registration Number
- NCT02634697
- Lead Sponsor
- Massachusetts General Hospital
- Brief Summary
The purpose of this study is to determine if an eight week multimodal Relaxation Response Resiliency Program (3RP) intervention can effectively improve symptom severity, frequency and quality of life (Q.O.L) in atrial fibrillation (AF) patients. This will be measured by a reduction in AF symptom score, perceived stress, anxiety, hostility and depression.
- Detailed Description
Atrial fibrillation (AF) is a very common cardiovascular disease. Symptoms include dizziness, palpitations, lightheadedness, shortness of breath, fatigue and exercise intolerance. AF is also associated with a high risk of complications like thrombo-embolism and stroke, heart failure, dementia. The presence and severity of these symptoms and complications adversely affect a patient's health related quality of life. Improvement in quality of life (QOL) is an important measure for evaluating response to treatment in AF patients. Depression and anxiety are significant part of the psychosocial burden faced by approximately one-third of AF patients, and are important components that effect QOL in these patients. In this study the investigators will apply the 3RP (Relaxation Response Resiliency Program - developed at the Benson Henry Institute at Massachusetts General Hospital) intervention among AF patients to assess the reduction in their stress, anxiety and depression levels and the reduction in AF symptom burden and severity.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 15
- Age: 18-90 years
- Diagnosed with documented recurrent symptomatic paroxysmal atrial fibrillation
- Currently on stable medical therapy for AF and willing to continue on the same treatment regimen for 8 weeks while participating in the study.
- No current or prior practice of yoga, meditation, guided imagery or other techniques that elicit relaxation response (RR).
- Able to provide informed consent and to understand written and spoken English.
- End Stage renal failure or heart failure, severe unstable medical or psychiatric disease
- Patients deemed unable to complete protocol due to cognitive or other reasons.
- Patients on psychoactive medications will have eligibility determined by the PI or MD co-investigator on a case-by-case basis, and will be admitted to the study if medication is deemed stable
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description 3RP Intervention Group Relaxation Response Resiliency Program AF Patients will undergo the 3RP intervention which will comprise of the following: i. One-one-one session: each subject will spend an hour with a clinician to set specific goals for the intervention. They will also answer questionnaires. ii. ECG monitoring: Enrolled subjects may be monitored with an ECG at some point after the time of consent up to the day of the one-on-one session, and again after completing the 8 weeks. iii. Weeks 1 - 8: subjects will meet with the clinician/staff member as a group once a week for 1.5 hours each where they will be taught a variety of techniques to elicit the relaxation response as well as other cognitive skills. At the end of the 4th (mid-point) and 8th (last) weekly session, subjects will answer questionnaires. iv. 6 month follow up: 3 months after the final 3RP session to answer questionnaires. v. Subjects will be asked to keep track of their AF episodes during the course of the study. 3RP Waitlist Control Group Relaxation Response Resiliency Program The Control Group will wait for 6 months (from the time the Intervention group starts the 3RP intervention) and then will undergo the same study procedures as the intervention group - except for the 6 month follow up.
- Primary Outcome Measures
Name Time Method Measure of Current Status (MOCS-A) Change between Baseline (week 0), mid-intervention (week 4), post-intervention (week 9), and 3-month follow up (week 13 or week 26) The MOCS-A is a 13-item measure assessing participants' current self-perceived status on several skills such as: the ability to relax at will, recognize stress-inducing situations, restructure maladaptive thoughts, be assertive about needs, and choose appropriate coping responses as needed. Responses are made on a 7-point scale with higher scores reflecting higher life satisfaction.
AF Symptoms Severity and Burden questionnaire Change between Baseline (week 0), mid-intervention (week 4), post-intervention (week 9), and 3-month follow up (week 13 or week 26) A 19-item measure assessing the severity, burden, and impact of one's atrial fibrillation symptoms.
- Secondary Outcome Measures
Name Time Method Buss-Perry Hostility Scale Change between Baseline (week 0), mid-intervention (week 4), post-intervention (week 9), and 3-month follow up (week 13 or week 26) A 29-item questionnaire that measures a one's levels of aggression.
The Gratitude Questionnaire (GQ-6) Change between Baseline (week 0), mid-intervention (week 4), post-intervention (week 9), and 3-month follow up (week 13 or week 26) The GQ-6 revised is a 6-item measure that assesses individual differences in the proneness to experience gratitude in daily life. Scores range from 6-42, with a higher score indicating a greater sense of gratitude.
FACIT-Spirituality Change between Baseline (week 0), mid-intervention (week 4), post-intervention (week 9), and 3-month follow up (week 13 or week 26) Measures spiritual well-being (sense of meaning in life and the sense of strength in one's faith).
Medical Outcomes Study (MOS) Social Support Survey Change between Baseline (week 0), mid-intervention (week 4), post-intervention (week 9), and 3-month follow up (week 13 or week 26) The MOS Social Support Survey measures various dimensions of social support.
Lifestyle Questionnaire Change between Baseline (week 0), mid-intervention (week 4), post-intervention (week 9), and 3-month follow up (week 13 or week 26) Measures physical activity and health behaviors.
RR Adherence Questionnaire Change between Baseline (week 0), mid-intervention (week 4), post-intervention (week 9), and 3-month follow up (week 13 or week 26) Assesses the number of days a week where participants practiced RR skills.
General Self-Efficacy Scale Change between Baseline (week 0), mid-intervention (week 4), post-intervention (week 9), and 3-month follow up (week 13 or week 26) Measures optimistic self-beliefs to cope with a variety of difficult demands in life.
Visual Analog Stress Scale Change between Baseline (week 0), mid-intervention (week 4), post-intervention (week 9), and 3-month follow up (week 13 or week 26) Measures one's distress, stress, and ability to cope with that stress over the past week on a scale from 0 to 10.
Cognitive and Affective Mindfulness Scale (CAMS) Change between Baseline (week 0), mid-intervention (week 4), post-intervention (week 9), and 3-month follow up (week 13 or week 26) Measures the degree to which individuals experience their thoughts and feelings.
Cigna Healthy Eating Scale Change between Baseline (week 0), mid-intervention (week 4), post-intervention (week 9), and 3-month follow up (week 13 or week 26) A 7-item self-report instrument that measures behavioral eating.
Interpersonal Reactivity Index (IRI) Change between Baseline (week 0), mid-intervention (week 4), post-intervention (week 9), and 3-month follow up (week 13 or week 26) The IRI assesses the cognitive and affective dimensions of empathy.
Life Orientation Test (LOT) Optimism Scale Change between Baseline (week 0), mid-intervention (week 4), post-intervention (week 9), and 3-month follow up (week 13 or week 26) The LOT Optimism Scale measures individual differences in generalized optimism versus pessimism.
Pittsburgh Sleep Quality Index (PSQI) Change between Baseline (week 0), mid-intervention (week 4), post-intervention (week 9), and 3-month follow up (week 13 or week 26) Assesses sleep quality and discriminates between good and poor sleepers.
Fatigue and Distress Analogue Scale Change between Baseline (week 0), mid-intervention (week 4), post-intervention (week 9), and 3-month follow up (week 13 or week 26) Measures one's distress and fatigue over the past week on a scale from 0 to 10.
Medication Use Questionnaire Change between Baseline (week 0), post-intervention (week 9), and 3-month follow up (week 13 or week 26) Patients list their medication name, dosage, and frequency.
Generalized Anxiety Disorder 7-item (GAD-7) Change between Baseline (week 0), mid-intervention (week 4), post-intervention (week 9), and 3-month follow up (week 13 or week 26) A brief measure for assessing generalized anxiety disorder
Positive and Negative Affect Schedule (PANAS) Change between Baseline (week 0), mid-intervention (week 4), post-intervention (week 9), and 3-month follow up (week 13 or week 26) The PANAS comprises two mood scales, one that measures positive affect and the other which measures negative affect.
Patient Health Questionnaire (PHQ) Change between Baseline (week 0), mid-intervention (week 4), post-intervention (week 9), and 3-month follow up (week 13 or week 26) The PHQ measures symptoms of depression and functional impairment.
Penn State Worry Questionnaire (PSWQ) Change between Baseline (week 0), mid-intervention (week 4), post-intervention (week 9), and 3-month follow up (week 13 or week 26) Measures the trait (or tendency towards) worry in individuals.
Perceived Stress Scale (PSS-10) Change between Baseline (week 0), mid-intervention (week 4), post-intervention (week 9), and 3-month follow up (week 13 or week 26) The PSS is a widely used psychological instrument for the measurement of the perception of stress. This 10-itam scale is designed to measure the degree to which situations in one's life are appraised, or considered stressful. The scores range from 0-40, with a higher score indicating higher perceived stress. Items were designed to detect how unpredictable, uncontrollable and overloaded respondents find their lives.
Smoking Questionnaire Change between Baseline (week 0), mid-intervention (week 4), post-intervention (week 9), and 3-month follow up (week 13 or week 26) Measures the prevalence and frequency of an individual's smoking habits.
Trial Locations
- Locations (1)
Massachusetts General Hospital
🇺🇸Boston, Massachusetts, United States