[Psychological intervention and heart failure: from theory to clinical practice]

The management of chronic heart failure patients is complicated by the presence of multiple comorbid conditions, polypharmacy, psychosocial concerns and difficulties with adherence to complex medication, dietary regimen, smoking cessation and correct physical activity. Taken together, these factors contribute to the persistently high hospitalization and mortality rates as well as to the poor quality of life of these patients. In fact the progressive worsening of symptoms such as fatigue, breathlessness, anxiety and depression may have a negative impact on the patient's quality of life. Nevertheless a psychological intervention may contribute positively to enhance functional capacity and quality of life, and potentially to improve survival in patients with heart failure. On the basis of our experience and the scientific literature, we describe in this paper a psychological program for such patients. The psychometric tests used in the assessment, the psychological interventions to improve emotional reactions and the educational programs for disease management are analysed.