Journal of Isfahan Medical School

Journal of Isfahan Medical School

Comparing the Effectiveness of Cognitive-Behavioral Therapy and Exercise Therapy on the Tolerance of Ambiguity and Psychological Distress in Heart Failure Patients

Document Type : Original Article (s)

Authors
Alireza Seyfi Ardali 1
Hosein Safavi 2
Yoones Shahbazi 3
Mohammad Heydari 4
1 MSc in Medical-Surgical Nursing, Student Research Committee, Najafabad Branch, Islamic Azad University, Najafabad, Iran
2 MSc in Psychiatric Nursing, Community Health Research Center, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran
3 MSc in Medical-surgical Nursing, Research Center for Development of Nursing and Midwifery Sciences, Najafabad Branch, Islamic Azad University, Najafabad, Iran
4 Associate Professor, Department of Disasters and Emergencies, Community-Oriented Nursing Midwifery Research Center, Nursing and Midwifery School, Shahrekord University of Medical Sciences, Shahrekord, Iran
10.48305/jims.v44.i853.0269
Abstract
Introduction: Cardiovascular diseases are the most common cause of human mortality in the world. This study was conducted to compare the effectiveness of cognitive-behavioral therapy and exercise therapy on the tolerance of ambiguity and psychological distress in heart failure patients.
Methods: This study was applied in terms of purpose and quasi-experimental in terms of method with a pre-test-post-test design with a control group. The statistical population included all heart failure patients at Hajar Hospital, Shahrekord in 1404. Of these, 45 people were selected using convenience sampling and randomly assigned to three groups of 15 people (control, exercise therapy, cognitive-behavioral therapy).
Findings: The results obtained from multivariate analysis of covariance showed that there was a significant difference between the post-test scores of psychological distress and tolerance of ambiguity between the experimental and control groups (P < 0.05). The data were analyzed using multivariate analysis of covariance (MANCOVA) and independent t-test in SPSS-27 software. Findings: The results of multivariate analysis of covariance showed that both interventions resulted in a significant reduction in psychological distress and a significant increase in tolerance of ambiguity compared to the control group (P < 0.05).
Discussion and Conclusion: The findings support the effectiveness of both intervention approaches, but show a significant superiority of cognitive-behavioral therapy over exercise therapy in improving the psychological outcomes studied. It is suggested that this intervention be considered as a complementary component in comprehensive care programs for heart failure patients.

Highlights

 Alireza Seyfi Ardali: PubMed

Keywords
Cognitive Behavioral Therapy
Exercise Therapy
Psychological Distress
Heart Failure
Subjects
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Journal of Isfahan Medical School
Volume 44, Issue 853
1st Week, May
May and June 2026
Pages 269-278

  • Receive Date 15 October 2025
  • Accept Date 10 June 2026