{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T14:50:00Z","timestamp":1792162200916,"version":"4.4.0"},"reference-count":37,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Science Reports"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Psychological well\u2010being is a critical component of disease management and recovery in patients with cardiovascular disorders. Cognitive flexibility, as a key psychological determinant, significantly influences adaptive functioning and health\u2010related outcomes. Self\u2010regulation skills training has recently gained attention as an effective approach to enhancing mental health in individuals with chronic illnesses. This study aimed to assess the effect of a self\u2010regulation skills training program on improving cognitive flexibility among patients with heart failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>\n                      This randomized controlled trial included 69 hospitalized patients with heart failure who were randomly assigned to an intervention group (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200935) or a control group (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200934). Cognitive flexibility was assessed at baseline, immediately after the intervention, and 1 month later using the Cognitive Flexibility Inventory. The intervention group received six sessions of self\u2010regulation skills training over 3 weeks. The data were analyzed using SPSS software with independent t\u2010tests, chi\u2010square tests, Mann\u2013Whitney tests, and repeated\u2010measures ANOVA. This trial was registered in the Iranian Registry of Clinical Trials (IRCT20160927030002N4).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The findings demonstrated a significant time \u00d7 group interaction for total cognitive flexibility scores (F [2,66]\u2009=\u200916.66,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001, partial \u03b7\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090.34). Immediately afterward, the intervention group showed significantly higher cognitive flexibility compared with those of the control group (mean difference\u2009=\u20098.78 points; 95% CI: 3.64\u201313.92; Cohen's d\u2009=\u20090.80). At 1\u2010month follow\u2010up, the cognitive flexibility scores in the intervention group showed a slight decline compared with post\u2010intervention levels but remained modestly higher than baseline, whereas no meaningful change was observed in the control group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The findings suggest that self\u2010regulation skills training may serve as an effective intervention for enhancing cognitive flexibility and supporting the psychological well\u2010being of patients with heart failure.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hsr2.73306","type":"journal-article","created":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T02:32:20Z","timestamp":1790735540000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effect of a Self\u2010Regulation Skills Training Program on Cognitive Flexibility in Patients With Heart Failure: A Randomized Controlled Trial"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-2074-7323","authenticated-orcid":false,"given":"Erfan","family":"Mohammadzadeh","sequence":"first","affiliation":[{"name":"Student Research Center Faculty of Nursing and Midwifery Isfahan University of Medical Sciences Isfahan Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4847-2915","authenticated-orcid":false,"given":"Mousa","family":"Alavi","sequence":"additional","affiliation":[{"name":"Faculty of Nursing and Midwifery Isfahan University of Medical Sciences Isfahan Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0998-2421","authenticated-orcid":false,"given":"Mohammad","family":"Akbari","sequence":"additional","affiliation":[{"name":"Department of Psychiatric Nursing Faculty of Nursing and Midwifery Isfahan University of Medical Sciences Isfahan Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatemeh","family":"Lohrasebi","sequence":"additional","affiliation":[{"name":"Department of Psychiatric Nursing Faculty of Nursing and Midwifery Isfahan University of Medical Sciences Isfahan Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,29]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr2.11114"},{"key":"e_1_2_11_3_1","unstructured":"World Health Organization (WHO) \u201cCardiovascular Diseases (CVDs) \u201d last modified March 2025 https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/cardiovascular-diseases-(cvds)."},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/cvr\/cvac013"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcrp.2023.200212"},{"key":"e_1_2_11_6_1","volume-title":"Cardiovascular Disease","author":"Lopez E. 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