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Updated: Nov 24, 2025

A Novel Digital Platform for a Monitored Home-based Cardiac Rehabilitation Program
Published on: April 19, 2019
An attachment-based intervention for patients with cardiovascular disease and their partners: A proof-of-concept
Heather Tulloch1, Susan Johnson2, Natasha Demidenko1
1Division of Cardiac Prevention and Rehabilitation.
Insights
The Healing Hearts Together (HHT) intervention improved relationship quality, mental health, and quality of life for couples coping with cardiovascular disease (CVD). This attachment-based program showed significant benefits for both patients and partners.
Area of Science:
- Cardiology
- Psychology
- Relationship Science
Background:
- Couple distress is linked to cardiovascular disease (CVD) risk factors.
- Relationship support is associated with heart-healthy behaviors and better CVD outcomes.
Purpose of the Study:
- To evaluate the clinical benefits of the Healing Hearts Together (HHT) intervention.
- The HHT intervention is an attachment-based program designed to enhance relationship quality, mental health, and quality of life (QoL) for couples where one partner has CVD.
Main Methods:
- A total of 78 participants (39 couples) from a tertiary cardiac care center attended an 8-session HHT group.
- Validated self-report questionnaires (DAS, CSI, HADS, SF-36) were administered pre- and post-intervention.
- Analysis of variance and paired-sample t tests were used to assess changes in relationship quality, mental health, and QoL.
Main Results:
- Participants reported significant improvements in relationship distress (Dyadic Adjustment Scale, Couple Satisfaction Index) and depression.
- Statistically significant reductions in anxiety and improvements in physical and mental quality of life were observed.
- Patients showed significant improvements in QoL-mental component summary, while partners showed significant changes in anxiety.
Conclusions:
- The HHT intervention demonstrated significant benefits for both patients with CVD and their partners regarding relationship quality, mental health, and QoL.
- Further research through a larger randomized controlled trial is recommended to validate these findings.
Abstract:
Couple distress is associated with cardiovascular disease (CVD) risk factors, whereas support is associated with heart-healthy behaviors and better CVD outcomes.
Objective:
To assess the clinical benefit of the Healing Hearts Together (HHT) intervention, an attachment-based relationship enhancement program for couples in which 1 partner has CVD, on relationship quality, mental health, and quality of life (QoL).
Method:
Patients from a tertiary cardiac care center and their partners (N = 78; 39 couples) attended the 8-session HHT group. Participants completed validated, self-report questionnaires pre- and postintervention, including the Dyadic Adjustment Scale (DAS), Couple Satisfaction Index (CSI), Hospital Anxiety and Depression Scale (HADS), and the SF-36 (QoL). At intervention completion, participants completed a satisfaction survey. Between-groups comparisons (patient/partner) were examined with analysis of variance. Paired-sample t tests were used to assess changes over time with HHT participation for the complete sample and for patients and partners separately.
Results:
Many participants reported relationship and psychological distress at baseline. Clinically and statistically significant changes from pre to postintervention were observed for relationship distress (DAS: +7.8 points; p < .001; CSI changes [+3.6] were clinically significant) and depression (-1.8; p < .001), whereas statistically significant changes occurred for anxiety (-1.5; p < .001), and physical (+2.1; p = .047) and mental (+3.3; p < .001) QoL. Patients, but not partners, reported statistically significant changes in QoL-mental component summary. Clinically and statistically significant changes were observed for anxiety for partners, but not patients.
Conclusions:
The HHT intervention was beneficial for patients' and partners' relationship quality, mental health, and QoL. A larger randomized controlled trial evaluating the impact of this intervention on relationship quality, mental health and QoL is warranted. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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