Effects of Positive Mood and Exercise on Mortality and Hospitalizations

Madelein Hoogwegt, MSc Promovenda Center of Research on Psychology in Somatic diseases (CoRPS) Department of Medical and Clinical Psychology Kamer P711 Tilburg University 5000 LE TilburgMedicalResearch.com Interview with:
Madelein Hoogwegt, MSc
Promovenda
Center of Research on Psychology in Somatic diseases (CoRPS)
Department of Medical and Clinical Psychology
Kamer P711 Tilburg University 5000 LE Tilburg
MedicalResearch.com: What are the main findings of the study?

Answer: The main finding was that we found a significant relation between positive affect and mortality, and that exercise explained this relationship. With respect to the second outcome, hospitalization, we found a significant relation between positive affect and hospitalization, a significant relation between positive affect and hospitalization, but exercise did not mediate this relationship.

MedicalResearch.com: What should clinicians and patients take away from your report?

Answer: The most important implication of this study is now we know that exercise plays an important role in the association between positive affect and prognosis, we should focus not only on increasing positive affect in cardiac rehabilitation, but we should also make sure that patients perform exercise on a regular basis, as exercise is both associated to increased levels of positive affect, and to improved prognosis. The beneficial effects of positive affect induction and increasing daily exercise could be increased when both aspects are implemented in rehabilitation settings. Practitioners should emphasize that incorporating a healthy exercise pattern is of utmost importance, not only to recover from the cardiac event and to stay in good condition, but also to improve emotional state. In addition, screening for emotional distress is important, as we know that patients with emotional distress are at high risk of not performing regular exercise due to their mood state. Screening for emotional distress, and importantly, subsequent inclusion of the distressed patients in rehabilitation or psychological interventions, is crucial when it comes to decreasing the devastating effects of emotional distress on both quality of life and prognosis.

Patients should try to incorporate exercise in their daily pattern. Although this is more easily said than done, there are lots of ways to facilitate this. For example, patients can participate in a cardiac rehabilitation program, in which exercise is an important component and is guided by experienced physicians and physiotherapists, or ask family members to join physical activities. In case of anxiety for performing physical activities, which is a normal reaction pattern after a cardiac event, counseling by a psychologist could also help to gain and maintain a healthy exercise pattern, as the psychologist can help the patient reduce anxiety and regain confidence in one’s body.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Answer: It is important that more research is performed on the effect of exercise intensity and type of exercise. This is something that we have not been able to incorporate in our analyses. Furthermore, the research should be expanded to other races and societies, although we do not expect results to be different. Most importantly, intervention trials should be started in order to investigate how we can best combine psychological and physical counseling, in order to reduce emotional distress and improve life style in patients with cardiac disease.

Citation:

Exercise mediates the association between positive affect and 5-year mortality in patients with ischemic heart disease

Madelein T. Hoogwegt, Henneke Versteeg, Tina B. Hansen, Lau C. Thygesen, Susanne S. Pedersen, and Ann-Dorthe Zwisler

Circ Cardiovasc Qual Outcomes. 2013;CIRCOUTCOMES.113.000158published online before print September 10 2013, doi:10.1161/CIRCOUTCOMES.113.000158