Harvard Medical School: Tai Chi Empowers Patients with Heart Failure
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May 23, 2016 -
In a project collaborated by
Harvard Medical School, one of its affiliates and New England School of
Acupuncture, researchers aimed to qualitatively explore perceived physical and
psychosocial effects and overall patient experience associated with a
12-week tai chi intervention and an education group in a clinical trial of
patients with chronic heart failure.
They randomized 100 patients with
chronic systolic heart failure to a 12-week group Tai Chi program or an
education control. The participants aged between 59 and 77. At 12-weeks,
semi-structured interviews were conducted on a random subset (17 from the Tai
Chi group and 15 from the control group. Two independent reviewers extracted
information using grounded-theory methods for emergent themes.
They explored similarities and
differences in themes/sub-themes between the groups, and examined qualitative
association with changes from baseline to post-intervention in previously
reported quantitative measures (e.g., Minnesota Living with HF, Cardiac Exercise
Self Efficacy and Profile of Mood States).
The researchers identified themes
related to the patient's experience of illness, perceptions of self, and
relationship to others. Specific psychosocial and physical benefits were
described. Common themes emerged from both groups including: social support and
self-efficacy related to activity/exercise and diet.
The Tai Chi group, however, also
exhibited a more global empowerment and perceived control. Additional themes in
Tai Chi included mindfulness/self-awareness, decreased stress reactivity, and
renewed social role. These themes mirrored improvements in previously reported
quantitative measures (quality-of-life, self-efficacy, and mood) in Tai Chi
compared to control. Patients in Tai Chi also reported physical benefits (e.g.,
decreased pain, improved energy, endurance, flexibility).
In conclusion, positive themes
emerged from both groups, although there were qualitative differences in
concepts of self-efficacy and perceived control between groups. Those in Tai
Chi reported not only self efficacy and social support, but overall empowerment
with additional gains such as internal locus of control, self-awareness and
stress management. Future studies of mind-body exercise might further examine
perceived control, self-efficacy, and locus-of-control as potential mediators of
Their findings are reported in the May 2016 issue of
Public Library of Science one.