Motivational interviewing to change quality of life for people with chronic heart failure: a randomised controlled trial

BACKGROUND: Patients with chronic heart failure have a reduced quality of life due in part to their limited range of physical activity and independence. OBJECTIVES: The paper examines whether a physical activity 'lifestyle' intervention, based on motivational interviewing, will improve quality of life at five months from baseline, compared with conventional treatment. METHODS: Sixty older patients with chronic heart failure were randomly assigned to either a 'standard care', 'motivational interviewing' or 'both' treatment groups for five months in 2002. The primary outcome measures were the Medical Outcomes Short Form-36 Health Survey, the disease-specific Minnesota Living with Heart Failure questionnaire and the Motivation Readiness for Physical Activity scale. RESULTS: There were non-significant differences between the groups at baseline for age, coronary risk factors, severity of chronic heart failure, ejection fraction, specific laboratory tests, length of hospitalisation, medication and social support. Following treatment there was a significant increase (p<0.05) for three of the dimensions of the health survey in the 'motivational interviewing' group. All groups improved their scores (p<0.05) on the heart failure questionnaire. Over the five month period there was a general trend towards improvements in self-efficacy and motivation scores. CONCLUSIONS: This study has demonstrated that a 'motivational interviewing' intervention, incorporating behaviour change principles to promote physical activity, is effective in increasing selected aspects of a general quality of life questionnaire and a disease-specific quality of life questionnaire. Thus a 'motivational interviewing' approach is a viable option compared with traditional exercise programming. It is important to test these motivational interviewing interventions more widely, especially to match individuals to treatments.