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In order to test the effect of systematic supervised physical training, we divided a total of 129 children and adolescents with congenital heart disease into a group undergoing intervention and a control group. All patients underwent exercise tests, measurements of physical activity, and a survey of psychosocial factors. An improvement in uptake of peak level of oxygen was observed after intervention. There was also an improvement in physical activity in both groups measured by a monitor, although this was significant only in those with intervention. The psychosocial scales measured by the Child Behavior Checklist showed a decrease in internalizing scores for those subjected to intervention. This was decreased due to decreased withdrawal and somatic complaints. In conclusion, we recommend systematic supervised training, including testing of routine follow-ups, in patients with congenital heart disease.

During their rehabilitation stay at Beitostølen Healthsports Centre patients daily participate in varied forms of adapted physical activities, physiotherapy, and leisure and social activities. Support for mental and social problems is offered. A total of 189 patients were invited for quality of life assessment; 132 consented to participate, and 107 completed the investigation. Nottingham Health Profile (NHP), Life Satisfaction Scale (LiSat) and three questions regarding self-rated physical and mental health and disability were used for assessment. For NHP total score, satisfaction with life as a whole (LiSat), and questions regarding self-rated physical/mental health and disability improvements from one month before until three months after the stay were statistically significant. Improvements were also significant for subscales regarding emotional reactions, energy, pain, sleep, sexual life, family life, hobbies/interests, leisure situation and social isolation. Although this study did not include controls, the results indicate that a rehabilitation stay with adapted physical activities improves the quality of life of the patients until at least three months after the stay. Effects are probably mediated through improvement of self-efficacy.

78 patients were recruited from a local occupational health clinic service and from general practices. They were allocated randomly to either an intervention group (40 patients) for a patient-centred approach to health care, or to a control group (38 patients) for conventional care. The patients were free to express their attitudes to health-related behaviour and to suggest behaviour changes. Emphasis was placed on the doctor being an active listener, with an understanding and sympathetic approach to the patient. 27 of the 40 patients in the intervention group suggested initiating change. After six weeks 24 patients reported having accomplished changes. There was a more significant reduction in the use of tobacco in the intervention group (p = 0.05) than in the control group. The patients' evaluation of the two approaches was the same, except for four patients in the intervention group, who felt provoked. Psychological well-being was measured using the Goldberg General Health Questionnaire, 28 item version (GHQ-28). In the control group there was a significant improvement in the GHQ-28 score (p = 0.022) after six weeks; the intervention group showed a near-significant improvement (p = 0.068) after 12 weeks. There was no significant difference in the change in GHQ-28 score between the groups. A patient-centred approach to health care may have potential for changing attitudes to health-related behaviour and bringing about actual behaviour changes. Further research with more extensive material is needed to confirm both this, and the effects on psychological well-being.