Psychological Care in Heart Failure Rehabilitation: A Meta-Analysis

This meta-analysis aimed to evaluate the efficacy of psychological therapy versus conventional therapy within cardiac rehabilitation programs for individuals with heart failure (HF). The systematic review included 19 randomised controlled trials (RCTs), including 2,196 HF patients, of whom 1,060 were assigned to standard care, and 1,136 underwent psychological interventions. This review was registered in PROSPERO (CRD420250651620). The meta-analysis demonstrated that psychological interventions were not significantly more effective than conventional care in improving Kansas City Cardiomyopathy Questionnaire (KCCQ) scores (standardised mean difference [SMD] = 0.57, 95% CI: -0.61 to 1.75). Similarly, minimal differential effects were observed in self-care maintenance [SMD = 0.33, 95% CI: -0.03 to 0.69] and self- care confidence [SMD = 0.13, 95% CI: -0.08 to 0.35] among patients with HF. Psychological interventions demonstrated significant reductions in anxiety among HF patients versus routine care [SMD = -0.81, 95% CI: -1.52 to -0.09]. Notably, improvements were also observed in phy- sical capacity metrics (6-minute walking test: SMD = 0.35, 95% CI: 0.01-0.69) and clinical outcomes (readmission rate: OR = 0.28, 95% CI: 0.14-0.56). These findings collectively indicate that patient-centred psychotherapy significantly enhances both psychological well-being and physiological recovery in HF populations. However, the timing and population of intervention are still worth discussing; for example, group or partner nursing methods may be more suitable.