Efficacy of Alternative Cardiac Rehabilitation Delivery Formats in Improving Psychological Symptoms after Coronary Artery Bypass Grafting
-
Mozhgan Saeidi
,
Ali Soroush
,
Saeid Komasi
,
Agostino Brugnera
,
Marco Patucelli
,
Danilo Carrozzino
,
Mario Fulcheri
,
Angelo Compare
Abstract
Background: Health-care systems always strive for alternative cardiac rehabilitation (CR) models to ensure that options available to patients better fit their needs, risk factor profiles, and preferences. We assessed the effects of hospital-based cardiac rehabilitation (HBCR) and hybrid cardiac rehabilitation (HCR) on psychological symptoms (i.e., anxiety, depression, and stress) among patients following coronary artery bypass graft surgery (CABG).
Methods: This cross-sectional study recruited 115 CABG patients who were referred to the Department of Cardiac Rehabilitation at Imam Ali Hospital in the Iranian city of Kermanshah between January and May 2016. The patients were assigned to 1 of the 2 programs of HBCR (26 sessions) and HCR (10 sessions). The study population’s psychological symptoms were assessed using the Depression, Anxiety, and Stress Scale (DASS) before and after the intervention, and the data were analyzed using paired t-tests and ANCOVA.
Results: A total of 105 (91%) patients concluded the CR program. Respectively, 50.8% and 26.2% of the participants in the HBCR and HCR programs were female. The mean age was 59.6±9.2 years in the HBCR group and 58.7±6.1 years in the HCR group. The ANCOVA results indicated that both HBCR and HCR programs were equally effective in reducing anxiety (P=0.001 vs. P=0.015) and stress (P=0.002 vs. P=0.003) among the CABG patients, while only HBCR was effective in alleviating depressive symptoms (P=0.001).
Conclusion: Our results demonstrated the efficacy of HBCR and HCR in diminishing stress and anxiety levels among the CABG patients. However, depression was affected only by HBCR.
Komasi S, Saeidi M, Montazeri N, Masoumi M, Soroush A, Ezzati P. Which factors unexpectedly increase depressive symptom severity in patients at the end of a cardiac rehabilitation program? Ann Rehabil Med 2015;39:872-879.
Heydarpour B, Saeidi M, Ezzati P, Soroush A, Komasi S. Sociodemographic predictors in failure to complete outpatient cardiac rehabilitation. Ann Rehabil Med 2015;39:863-871.
Korzeniowska-Kubacka I, Dobraszkiewicz-Wasilewska B, Bilińska M, Rydzewska E, Piotrowicz R. Two models of early cardiac rehabilitation in male patients after myocardial infarction with preserved left ventricular function: comparison of standard out-patient versus hybrid training programmes. Kardiol Pol 2011;69:220-226.
Clark RA, Conway A, Poulsen V, Keech W, Tirimacco R, Tideman P. Alternative models of cardiac rehabilitation: a systematic review. Eur J Prev Cardiol 2015;22:35-74.
Villani A, Malfatto G, Della Rosa F, Branzi G, Boarin S, Borghi C, Cosentino E, Gualerzi M, Coruzzi P, Molinari E, Compare A, Cassi M, Collatina S, Parati G. Disease management for heart failure patients: role of wireless technologies for telemedicine. The ICAROS project. G Ital Cardiol (Rome) 2007;8:107-114.
Korzeniowska-Kubacka I, Bilińska M, Dobraszkiewicz-Wasilewska B, Piotrowicz R. Hybrid model of cardiac rehabilitation in men and women after myocardial infarction. Cardiol J 2015;22:212-218.
Najafi F, Nalini M. Hospital-based versus hybrid cardiac rehabilitation program in coronary bypass surgery patients in western Iran: effects on exercise capacity, risk factors, psychological factors, and quality of life. J Cardiopulm Rehabil Prev 2015;35:29-36.
Szalewska D, Tomaszewski J, Kusiak-Kaczmarek M, Niedoszytko P, Gierat-Haponiuk K, Haponiuk I, Bakuła S. Influence of a hybrid form of cardiac rehabilitation on exercise tolerance in coronary artery disease patients with and without diabetes. Kardiol Pol 2015;73:753-760.
Nalini M. Outpatient cardiac rehabilitation use after coronary bypass surgery in the west of Iran. J Cardiopulm Rehabil Prev 2014;34:263-270.
Komasi S, Saeidi M. What is role of sex and age differences in marital conflict and stress of patients under cardiac rehabilitation program? ARYA Atheroscler 2016;12:138-145.
Lovibond PF, Lovibond SH. The structure of negative emotional states: comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behav Res Ther 1995;33:335-343.
Sahebi A, Asghari MJ, Salari RS. Validation of depression anxiety and stress scale [DASS-21] for an Iranian population. J Develop Psychol 2005;1:1-18. [Persian]
Dhar AK, Barton DA. Depression and the link with cardiovascular disease. Front Psychiatry 2016;7:33.
Tully PJ. Psychological depression and cardiac surgery: a comprehensive review. J Extra Corpor Technol 2012;44:224-232.
Compare A, Zarbo C, Manzoni GM, Castelnuovo G, Baldassari E, Bonardi A, Callus E, Romagnoni C. Social support, depression, and heart disease: a ten year literature review. Front Psychol 2013;4:384.
Goldston K, Baillie AJ. Depression and coronary heart disease: a review of the epidemiological evidence, explanatory mechanisms and management approaches. Clin Psychol Rev 2008;28:288-306.
Williams MA, Ades PA, Hamm LF, Keteyian SJ, LaFontaine TP, Roitman JL, Squires RW. Clinical evidence for a health benefit from cardiac rehabilitation: an update. Am Heart J 2006;152:835-841.
Bahremand M, Saeidi M, Takallo F, Komasi S. Comparison of depression, anxiety, and stress between mild and severe non-cardiac chest pain. Thrita 2016;5:e32752.
Kupfer DJ. Anxiety and DSM-5. Dialogues Clin Neurosci 2015;17:245-246.
Saeidi M, Komasi S, Heydarpour B, Karim H, Nalini M, Ezzati P. Predictors of clinical anxiety aggravation at the end of a cardiac rehabilitation program. Res Cardiovasc Med 2015;5:e30091.
| Files | ||
| Issue | Vol 13 No 3 (2018): J Teh Univ Heart Ctr | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/jthc.v13i3.129 | |
| Keywords | ||
| Coronary artery bypass Cardiovascular rehabilitation Hospital centralized services Home care services | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
