The effects of PERMA model-based positive psychological intervention on fear of disease progression and subjective well-being in patients after coronary artery bypass grafting: a retrospective cohort study.

BACKGROUND: Patients undergoing coronary artery bypass grafting (CABG) frequently experience fear of disease progression (FoP) and diminished psychological well-being during the postoperative recovery period. The PERMA model, encompassing Positive emotion, Engagement, Relationships, Meaning, and Accomplishment, represents a comprehensive framework within positive psychology that may address these psychological challenges. However, the clinical effectiveness of PERMA-based interventions in cardiac surgery patients requires further empirical validation through retrospective analysis of real-world data.

METHODS: This retrospective cohort study analyzed medical records of 60 patients who underwent CABG at our institution between January 2023 and December 2025. Patients were categorized into a control group (n = 30) receiving conventional perioperative nursing care and an observation group (n = 30) receiving PERMA model-based psychological intervention in addition to standard care. Group allocation was determined retrospectively based on documented nursing care protocols, as patients treated by PERMA-trained nurses received the intervention while those treated by other nursing teams received standard care. Primary outcomes included FoP-Q-SF scores and PERMA-Profiler assessments. Secondary outcomes encompassed anxiety and depression scales, cardiac function parameters, and quality of life measures at three months post-discharge.

RESULTS: At three months post-intervention, the observation group demonstrated significantly lower FoP-Q-SF total scores compared to the control group (24.5 ± 4.8 vs. 31.2 ± 5.5, P < 0.001). All five PERMA dimensions showed statistically significant improvements in the intervention group (P < 0.05). Furthermore, the observation group exhibited superior cardiac rehabilitation outcomes, including enhanced left ventricular ejection fraction, greater six-minute walk distance, and improved rehabilitation adherence.

CONCLUSION: PERMA model-based positive psychological intervention is associated with reduced fear of disease progression, enhanced subjective well-being, and improved postoperative recovery indicators in CABG patients. These findings support the integration of this intervention framework into cardiac surgery nursing protocols, though prospective randomized trials are needed to confirm causal relationships.