Development of a psychosocial intervention in cardiac rehabilitation: a co-creation process

Background

Psychological distress is common among cardiac patients, yet psychosocial management remains inconsistently integrated into routine cardiac rehabilitation. Structured, person-centred approaches that can be embedded within existing programmes are needed. This study reports the systematic development of a psychosocial intervention integrated into routine cardiac rehabilitation and presents a prototype.

Methods

The intervention was developed through a co-creation process involving healthcare professionals, patients, informal caregivers, and researchers across three Danish municipalities. Guided by the UK Medical Research Council framework for complex interventions, operationalised through the co-production framework by Hawkins et al., the process comprised iterative workshops, perspectives of interest-holders, and prototyping in clinical practice.

Results

The co-creation process resulted in an intervention comprising three components: 1) a structured psychosocial consultation supported by a dialogue tool, 2) targeted sessions (3–5 sessions) based on metacognitive therapy for patients requiring additional support and 3) a systematic focus on mental well-being throughout cardiac rehabilitation. Healthcare professionals underwent training and participated in an initial testing phase, which informed refinements of the intervention.

Conclusions

A co-created psychosocial intervention was systematically developed and tailored to routine cardiac rehabilitation through an iterative process integrating evidence, perspectives of interest-holders, and practice-based testing. The intervention provides a structured approach to psychosocial management, enabling systematic identification of psychological distress and delivery of targeted support within existing workflows. By embedding psychosocial management into routine practice, the intervention addresses current gaps in consistency and implementation. The intervention is now ready for feasibility testing.

Key messages

• Co-creation enables the development of psychosocial interventions that are aligned with routine practice and responsive to needs of interest-holders.

• Structured integration of psychosocial management, including approaches based on metacognitive therapy, can support identification and management of psychological distress in cardiac rehabilitation.