Testing a self-help intervention program for people with peripheral arterial disease: a pilot study among 10 patients

Given that PAD is a progressive disease with decreasing functioning and
decreasing quality of life, and given the prevalence of depression among PAD
patients and its assumed influence on the progression of a chronic disease,
there is a need to examine what form of psychological support might help PAD
patients to endure the course of the disease process. Therefore recent research
has focused on the identification of risk factors and protective factors
associated with the development of emotional problems in response to PAD. The
results had two important outcomes: 1) that negative thinking styles (such as
rumination, catastrophizing) are important risk factors for the development of
emotional problems; and 2) that goal re-engagement strategies or putting effort
towards new, meaningful goals are protective factors against the development of
emotional problems in response to the PAD. On basis of these results, it has
been suggested that self-help psychological intervention programs should be
developed for people with PAD including both of these components. Studies in
other illness populations already showed positive effects of self-help
intervention programs in improving psychological health. The present study is a
pilot study to examine whether such a self-help program would be useful for
people with peripheral arterial disease as well.

To examine whether a self-help psychological intervention program, based on
relaxation, changing negative coping styles and finding new goals would be
useful for people with PAD.

In this pilot study, 10 PAD patients with mild depression scores (as assessed
by the HADS) will be invited by their doctor in attendance to read and try-out
the self-help program. People with cognitive impairments and people over 80
years will not be included. Approaching patients will occur according to a
detailed schedule. People will receive information about the study and an
informed consent form. Confidentiality is warranted. If a person is willing to
participate, he or she receives the self-help program. After one week people
are contacted by telephone by the doctor in attendance to ask about the
progress. After four weeks, the participant will be contacted again by
telephone to ask feedback about the program. They are also asked to answer the
7 items of the HADS depression scale again in order to be able to determine
difference scores before and after the program.

The self-help program consists of a workbook and a work program. The content of
the program is based on 3 themes: mindfulness-based relaxation, bringing about
cognitive changes, and working on finding new goals. In the book, participants
are suggested to work on the intervention 4 days a week (1 hour per day) for a
period of 4 weeks. The first week focuses on relaxation exercises, the second
and third week focuses on identifying and changing negative thoughts, and the
fourth week focuses on finding new goals in life.

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