ABSTRACT
BACKGROUND: To enhance effective prevention programs after myocardial infarction (MI), the study examined the effects and feasibility of mobile biofeedback training on heart rate variability (HRV-BF). METHODS: Forty-six outpatients aged 41 to 79 years with a documented MI were randomized to HRV-BF versus usual care. Generalized estimating equation (GEE) analyses were performed to test improvements in measures of short- and long-time HRV, namely, the standard deviation of the normal-to-normal intervals (SDNN) and well-being after 12 weeks of HRV-BF. RESULTS: There were intervention effects for short-time HRV (d > 0.4, p < 0.04), which were partly replicated in the GEE models that accounted for control variables: In the HRV-BF group, the high-frequency HRV (group × time interaction: ß = 0.59, p = 0.04) compensated for significantly lower baseline levels than the group with usual care. In an optimal dose sample (on average two HRV-BF sessions a day), SDNN significantly increased after HRV-BF (p = 0.002) but not in the waitlist control group. Compensatory trends of HRV-BF were also found for high-frequency HRV and self-efficacy. No adverse effects of the intervention were found but neither were effects on long-time HRV measures. CONCLUSION: The results showed the feasibility of self-guided HRV-BF for almost all post-MI patients. HRV-BF as an adjunctive behavioral treatment increased HRV, which is an indicator of lower cardiovascular risk, and self-efficacy, which suggests heightened psychological resilience. These benefits warrant confirmation and tests of sustainability in larger studies. TRIAL REGISTRATION: The trial has not been registered due to its starting point in 2017 predating the publication of the applicable CONSORT extension for reporting social and psychological intervention trials in 2018.
Subject(s)
Biofeedback, Psychology , Myocardial Infarction , Biofeedback, Psychology/methods , Heart Rate/physiology , Humans , Myocardial Infarction/therapy , Research DesignABSTRACT
PURPOSE: We examined 10 job characteristics in a large population-based sample and tested for positive and negative effects on mental health. In addition, we tested for possible effects on mental health from interactions with locus of control and self-esteem. METHODS: The sample comprised longitudinal data on 2353 male and 1960 female employees from the German socio-economic panel collected between 2010 and 2012. Mental health was assessed with the mental component summary score derived from the short-form 12 health survey. We computed hierarchical regression analyses while controlling for potential confounds and baseline mental health. Interaction effects were specified with post hoc simple slope analyses. RESULTS: Time pressure, interruptions, job insecurity, and conflicts were negative predictors of mental health in all models. The personal resource of self-esteem was a positive predictor. Moreover, there were interactions: opportunities for promotion were beneficial only for employees with medium or high levels of self-esteem, whereas the contrary was true for employees with very low self-esteem. Working on weekends was negatively related to mental health for people with moderate to low internal control but not for people with high internal control. CONCLUSIONS: The findings suggest that there are job demands that are related to poor mental health regardless of personal resources. These aspects are important to consider in workplace risk assessment. By contrast, with other job characteristics (e.g., opportunities for promotion, weekend work), the effects vary between individuals.
