{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T00:52:47Z","timestamp":1783471967917,"version":"3.55.0"},"reference-count":93,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2016,10,6]],"date-time":"2016-10-06T00:00:00Z","timestamp":1475712000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["British J Health Psychol"],"published-print":{"date-parts":[[2016,11]]},"abstract":"\n Objective<\/jats:title>\n \n Cardiac rehabilitation (\n CR<\/jats:styled-content>\n ) is considered the recommended secondary prevention treatment for cardiovascular diseases (\n CVD<\/jats:styled-content>\n ), in terms of health behaviours and, secondarily, better cardiac outcomes promotion. However, the role of psychiatric and psychosomatic distress on the efficacy of\n CR<\/jats:styled-content>\n is unclear. This research aimed to evaluate the impact of\n CR<\/jats:styled-content>\n on unhealthy behaviour modification and cardiac course, considering the moderating role of depression, anxiety, and psychosomatic syndromes.\n <\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n \n A longitudinal design between and within groups was employed. The assessment was repeated four times: at admission to\n CR<\/jats:styled-content>\n (T1), at discharge (T2), 6 (T3) and 12\u00a0months following\n CR<\/jats:styled-content>\n completion (T4).\n <\/jats:p>\n <\/jats:sec>\n \n Method<\/jats:title>\n \n One hundred and eight patients undergoing\n CR<\/jats:styled-content>\n versus 85 patients with\n CVD<\/jats:styled-content>\n not referred to\n CR<\/jats:styled-content>\n , underwent psychiatric, psychosomatic, and health behaviour assessment. The assessment included the Structured Clinical Interview for\n DSM<\/jats:styled-content>\n \u2010\n IV<\/jats:styled-content>\n (depression and anxiety), the interview based on Diagnostic Criteria for Psychosomatic Research,\n GOSPEL<\/jats:styled-content>\n Study questionnaire (health behaviours), Pittsburgh Sleep Quality Index, and 8\u2010item Morisky Medication Adherence Scale.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Cardiac rehabilitation was associated with maintenance of physical activity, improvement of behavioural aspects related to food consumption, stress management, and sleep quality. On the contrary, CR was not associated with weight loss, healthy diet, and medication adherence. Depression and psychosomatic syndromes seem to moderate the modification of specific health\u2010related behaviours (physical activity, behavioural aspects of food consumption, stress management, and pharmacological adherence).<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n In CR settings, an integrated assessment including both psychiatric and psychosomatic syndromes is needed to address psychological factors associated with unhealthy behaviour modification.<\/jats:p>\n <\/jats:sec>\n \n \n \n \n \n \n Statement of contribution<\/jats:bold>\n <\/jats:title>\n <\/jats:caption>\n \n \n What is already known on this subject?<\/jats:bold>\n <\/jats:italic>\n <\/jats:p>\n \n \n \n Cardiac rehabilitation (CR) is considered a class 1A treatment recommendation and the most cost\u2010effective model of secondary prevention to reduce cardiovascular events.<\/jats:p>\n <\/jats:list-item>\n \n There is evidence about the association between psychological distress and both unhealthy behaviour and cardiac course.<\/jats:p>\n <\/jats:list-item>\n \n Depression and psychosomatic distress, such as type A behaviour and demoralization, are frequently associated with CVD course. However, the role of psychiatric and psychosomatic distress in CR is not well known.<\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>\n \n \n What does this study add?<\/jats:bold>\n <\/jats:italic>\n <\/jats:p>\n \n \n \n CR exerted a protective effect on physical activity and a positive effect on eating behaviour, stress management, and quality of sleep.<\/jats:p>\n <\/jats:list-item>\n \n CR did not show any particular effect on smoking, overweight\/obesity, dietary habits, medication adherence, and patients\u2019 1\u2010year survival.<\/jats:p>\n <\/jats:list-item>\n \n Findings from this study suggest the importance to consider specific psychological and psychosomatic aspects in affecting lifestyle.<\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>\n <\/jats:boxed-text>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/bjhp.12204","type":"journal-article","created":{"date-parts":[[2016,6,18]],"date-time":"2016-06-18T01:12:51Z","timestamp":1466212371000},"page":"894-916","source":"Crossref","is-referenced-by-count":29,"title":["Unhealthy behaviour modification, psychological distress, and 1\u2010year survival in cardiac rehabilitation"],"prefix":"10.1111","volume":"21","author":[{"given":"Sara","family":"Gostoli","sequence":"first","affiliation":[{"name":"Department of Psychology University of Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renzo","family":"Roncuzzi","sequence":"additional","affiliation":[{"name":"Division of Cardiology Bellaria Hospital Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Urbinati","sequence":"additional","affiliation":[{"name":"Division of Cardiology Bellaria Hospital Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donald E.","family":"Morisky","sequence":"additional","affiliation":[{"name":"Department of Community Health Sciences UCLA Fielding School of Public Health Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Rafanelli","sequence":"additional","affiliation":[{"name":"Department of Psychology University of Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,10,6]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-642-69746-3_2"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/0749\u20105978(91)90020\u2010T"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/HCR.0b013e318220a7c9"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.books.9780890423349"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2015.10.044"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1348\/014466601164939"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1176\/ajp.140.3.273"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.ejcn.1601575"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2011.12.017"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2012.11.017"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.atherosclerosis.2004.08.035"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/HCR.0b013e318293b47b"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/0165\u20101781(89)90047\u20104"},{"key":"e_1_2_6_15_1","unstructured":"Cardiac Rehabilitation Guideline Panel. 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