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Research Library

Effects of Brief Mindfulness‑Based Cognitive Behavioural Therapy on Health‑Related Quality of Life and Sense of Coherence in Atrial Fibrillation Patients

    • Published: 2018
    • Dan Malm1,2, Bengt Fridlund1, Helena Ekblad1, Patric Karlström1,2, Emma Hag1,2 and Amir H. Pakpour1,3
    • European Journal of Cardiovascular Nursing. DOI 10.1177/1474515118762796, 2018.1. School of Health; Welfare, Jönköping University, Jönköping, Sweden. 2. Department of Internal Medicine, County Hospital Ryhov, Jönköping, Sweden. 3. Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.
    • Download the complete paper, click here.



The aim of this study was to evaluate the effects of a brief dyadic cognitive behavioural therapy (CBT) programme on the health-related quality of life (HRQoL), as well as the sense of coherence in atrial fibrillation patients,up to 12 months post atrial fibrillation.


A longitudinal randomised controlled trial with a pre and 12-month post-test recruitment of 163 persons and their spouses, at a county hospital in southern Sweden. In all, 104 persons were randomly assigned to either a CBT (n=56) or a treatment as usual (TAU) group (n=55). The primary outcome was changes in the HRQoL (Euroqol questionnaire;EQ-5D), and the secondary outcomes were changes in psychological distress (hospital anxiety and depression scale;HADS) and sense of coherence (sense of coherence scale; SOC-13).


At the 12-month follow-up, the CBT group experienced a higher HRQoL than the TAU group (mean changes in the CBT group 0.062 vs. mean changes in the TAU group −0.015; P=0.02). The sense of coherence improved in the CBT group after the 12-month follow-up, compared to the TAU group (mean changes in the CBT group 0.062 vs. mean changes in the TAU group −0.16; P=0.04). The association between the intervention effect and the HRQoL was totally mediated by the sense of coherence (z=2.07, P=0.04).


A dyadic mindfulness-based CBT programme improved HRQoL and reduced psychological distress up to 12 months post atrial fibrillation. The sense of coherence strongly mediated the HRQoL; consequently, the sense of coherence is an important determinant to consider when designing programmes for atrial fibrillation patients.