The effects of positive psychology interventions on well-being and distress in patients with cardiovascular diseases: A systematic review and Meta-analysis

Objective: Positive psychology interventions (PPIs) have been found to be effective for psychiatric and somatic disorders. However, a systematic review and meta-analysis of studies examining the effectiveness of PPIs for patients with cardiovascular disease (CVD) is lacking. This systematic review and meta-analysis aims to syn-thesize studies examining the effectiveness of PPIs and to examine their effects on mental well-being and distress using meta-analyses.Methods: This study was preregistered on OSF (https://osf.io/95sjg/). A systematic search was performed in PsycINFO, PubMed and Scopus. Studies were included if they examined the effectiveness of PPIs on well-being for patients with CVD. Quality assessment was based on the Cochrane tool for assessing risk of bias. Three-level mixed-effects meta-regression models were used to analyze effect sizes of randomized controlled trials (RCTs).Results: Twenty studies with 1222 participants were included, of which 15 were RCTs. Included studies showed high variability in study and intervention characteristics. Meta-analyses showed significant effects for mental well-being (beta = 0.33) and distress (beta = 0.34) at post-intervention and the effects were still significant at follow-up. Five of the 15 RCTs were classified as having fair quality, while the remaining had low quality.Conclusion: These results suggest that PPIs are effective in improving well-being and distress in patients with CVD and could therefore be a valuable addition for clinical practice. However, there is a need for more rigorous studies that are adequately powered and that help us understand what PPIs are most effective for which patient.