Patients attachment patterns and response to a program for alleviating cardiovascular risk factors: a 1-year follow-up of patients in a patient education program

This study was a 1-year follow-up of 295 consecutive patients at a patient education centre and assessed how attachment style influenced the outcome o f the patient education program devised for individuals with multiple risk factors for cardiovascular disease. The program consisted of a 4-week resid ential program course, followed by a 4-day follow-up course a year later. I n our cohort study, the 295 consecutive patients (mean age = 52 years, S.D. = 9.2) with multiple risk factors for cardiovascular disease, showed an in itial overall reduction of 4.4 kg in weight (P = 0.0001) and a reduction of 17/11 mm in systolic and diastolic blood pressure (P = 0.0001 and 0.0001), The weight remained essentially the same at the follow-up I year later, wh ereas blood pressure tended to return to previous level. The attachment sty le was determined by means of a questionnaire: 87% were classified as 'secu re', 9% 'avoidant' and 5% as 'ambivalent'. After 4 weeks, the ambivalent ca tegory had reduced weight (body mass index (BMI)) more than the secure grou p (P = 0.04). At the I-year follow-up, the avoidant category showed a more pronounced reduction in diastolic blood pressure than the other groups (P = 0.001). Thus, it seems as if attachment style does have some influence on outcome. Patient education should take advantage of knowing patients' attac hment style. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.