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Effect of a Self-Regulation Skills Training Program on Cognitive Flexibility in Patients With Heart Failure: A
Erfan Mohammadzadeh1, Mousa Alavi2, Mohammad Akbari3
1Student Research Center Faculty of Nursing and Midwifery Isfahan University of Medical Sciences Isfahan Iran.
Background:
Psychological well-being 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-related outcomes. Self-regulation 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-regulation skills training program on improving cognitive flexibility among patients with heart failure.
Materials And Methods:
This randomized controlled trial included 69 hospitalized patients with heart failure who were randomly assigned to an intervention group (n = 35) or a control group (n = 34). 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-regulation skills training over 3 weeks. The data were analyzed using SPSS software with independent t-tests, chi-square tests, Mann-Whitney tests, and repeated-measures ANOVA. This trial was registered in the Iranian Registry of Clinical Trials (IRCT20160927030002N4).
Results:
The findings demonstrated a significant time × group interaction for total cognitive flexibility scores (F [2,66] = 16.66, p < 0.001, partial η2 = 0.34). Immediately afterward, the intervention group showed significantly higher cognitive flexibility compared with those of the control group (mean difference = 8.78 points; 95% CI: 3.64-13.92; Cohen's d = 0.80). At 1-month follow-up, the cognitive flexibility scores in the intervention group showed a slight decline compared with post-intervention levels but remained modestly higher than baseline, whereas no meaningful change was observed in the control group.
Conclusions:
The findings suggest that self-regulation skills training may serve as an effective intervention for enhancing cognitive flexibility and supporting the psychological well-being of patients with heart failure.
