An Investigation of the Benefits of Stress Management Within a Cardiac Rehabilitation Population

Campbell, Tavis S.; Stevenson, Andrea; Arena, Ross; Hauer, Thomas; Bacon, Simon; Rouleau, Codie R.; Cannon, C.; Stone, James A.

doi:10.1097/hcr.0b013e318265e0eb

“…181 A systematic review clearly demonstrates that CR improves HRQoL 182 and, for patients with elevated depressive mood, there was greater improvement in physical quality of life during CR if they were provided stress management in addition to exercise than exercise only. 183 Better baseline scores of HRQoL predicted fewer early dropouts from CR, although this effect was not independent of other variables. 184 Notably, a CR programme tailored for women significantly improved global HRQoL compared with traditional CR.…”

Section: Synopsis Of Psychosocial Risk Factors For Poor Prognosis Of mentioning

confidence: 89%

Psychosocial aspects in cardiac rehabilitation: From theory to practice. A position paper from the Cardiac Rehabilitation Section of the European Association of Cardiovascular Prevention and Rehabilitation of the European Society of Cardiology

Pogosova

¹

,

Saner²,

Pedersen

³

et al. 2014

Eur J Prev Cardiolog

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A large body of empirical research shows that psychosocial risk factors (PSRFs) such as low socio-economic status, social isolation, stress, Type-D personality, depression and anxiety increase the risk of incident coronary heart disease (CHD) and also contribute to poorer health-related quality of life (HRQL) and prognosis in patients with established CHD.PSRFs may also act as barriers to lifestyle changes and treatment adherence and may moderate the effects of cardiac rehabilitation (CR). Furthermore, there appears to be a bidirectional interaction between PSRFs and the cardiovascular system. Stress, anxiety and depression affect the cardiovascular system through immune, neuroendocrine and behavioural pathways. In turn, CHD and its associated treatments may lead to distress in patients, including anxiety and depression. In clinical practice, PSRFs can be assessed with single-item screening questions, standardised questionnaires, or structured clinical interviews.Psychotherapy and medication can be considered to alleviate any PSRF-related symptoms and to enhance HRQOL, but the evidence for a definite beneficial effect on cardiac endpoints is inconclusive. A multimodal behavioural intervention, integrating counseling for PSRFs and coping with illness should be included within comprehensive CR. Patients with clinically significant symptoms of distress should be referred for psychological counseling or psychologically focused interventions and/or psychopharmacological treatment. To conclude, the success of CR may critically depend on the interdependence of the body and mind and this interaction needs to be reflected through the assessment and management of PSRFs in line with robust scientific evidence, by trained staff, integrated within the core CR team. Word count of abstract: 246

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“…Psychological intervention, as indicated previously [ 28 ], was pivotal for any successful rehabilitation programs, as the burden of psychological problems like anxiety and depression, were found to be considerably high among CHD patients [ 29 ], and these problems were found to be negatively associated with motivation, adherence, maintenance and prognosis [ 29 ]. A variety of psychological intervention techniques, including stress management [ 30 ], relaxation and meditation practices [ 31 ], were applied in previous CR programs and shown favorable effects in terms of reduction in anxiety and depression scores as well as HRQoL score. In the present study, psychological intervention was also one of the key components of rehabilitation program and might be the explanation for the substantial changes of HADS anxiety and depression scores as well as SF-12 PCS and SF-12 MCS scores.…”

Section: Discussionmentioning

confidence: 99%

Community health service center-based cardiac rehabilitation in patients with coronary heart disease: a prospective study

Zhang

¹

,

Zhang

²

,

Wang

³

et al. 2017

BMC Health Serv Res

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BackgroundDespite considerable efforts to encourage participation, even in some developed countries, proportion of patients participating in institution-based cardiac rehabilitation (CR) programs remained sub-optimal. The present study was designed to investigate the acceptability of community health service center (CHSC)-based Cardiac Rehabilitation (CR), and examine its effectiveness in terms of changes in quality of life (QOL), psychological state and exercise capacity.MethodsA consecutive series of eligible patients was recruited from the health registration system of two CHSCs in Shijiazhuang, Hebei, China. Patients in intervention site were provided with CR (CR-group) while patients in non-intervention site were offered the usual care (UC-group). Data regarding health-related QOL (HRQoL), psychological state and exercise capacity (6-min walk test = 6MWT) were collected and compared at baseline and at 6 months post-intervention.ResultsAmong invited patients eligible for CR program, 65.3% participated, while 5.3% of the participants dropped out during follow-up. Patients in CR-group showed significant decrease in the scores for anxiety and depression as per the Hospital Anxiety and Depression Scale (HADS), along with marked increases in the Short-Form Health Survey (SF-12)-based Physical (PCS) and Mental Component Summary (MCS) scores. Moreover, the measurement of 6MWT showed a significant increase of 57.42 m walking distance among CR patients in contrast with a slight increase among UC patients.ConclusionsGiven the high participation and low withdrawal along with considerable improvements in HRQoL, psychological state and exercise capacity, CHSC was likely to be the optimal setting for implementing CR for patients with CHD in China.Trial registrationChiCTR-TRC-12002500. Registered 16 September 2012.

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“…183 Better baseline scores of HRQOL predicted fewer early dropouts from CR, although this effect was not independent of other variables. 184 Notably, a CR programme tailored for women significantly improved global HRQOL compared with traditional CR.…”

mentioning

confidence: 98%

Psychosocial Aspects in Cardiac Rehabilitation: From Theory to Practice. A Position Paper From the Cardiac Rehabilitation Section of The European Association of Cardiovascular Prevention and Rehabilitation of the European Society of Cardiology

Pogosova¹,

Saner²,

Pedersen³

et al. 2015

View full text Add to dashboard Cite

A large body of empirical research shows that psychosocial risk factors (PSRFs) such as low socio-economic status, social isolation, stress, Type-D personality, depression and anxiety increase the risk of incident coronary heart disease (CHD) and also contribute to poorer health-related quality of life (HRQL) and prognosis in patients with established CHD.PSRFs may also act as barriers to lifestyle changes and treatment adherence and may moderate the effects of cardiac rehabilitation (CR). Furthermore, there appears to be a bidirectional interaction between PSRFs and the cardiovascular system. Stress, anxiety and depression affect the cardiovascular system through immune, neuroendocrine and behavioural pathways. In turn, CHD and its associated treatments may lead to distress in patients, including anxiety and depression. In clinical practice, PSRFs can be assessed with single-item screening questions, standardised questionnaires, or structured clinical interviews.Psychotherapy and medication can be considered to alleviate any PSRF-related symptoms and to enhance HRQOL, but the evidence for a definite beneficial effect on cardiac endpoints is inconclusive. A multimodal behavioural intervention, integrating counseling for PSRFs and coping with illness should be included within comprehensive CR. Patients with clinically significant symptoms of distress should be referred for psychological counseling or psychologically focused interventions and/or psychopharmacological treatment. To conclude, the success of CR may critically depend on the interdependence of the body and mind and this interaction needs to be reflected through the assessment and management of PSRFs in line with robust scientific evidence, by trained staff, integrated within the core CR team. Word count of abstract: 246

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An Investigation of the Benefits of Stress Management Within a Cardiac Rehabilitation Population

Abstract: These findings suggest that stress management may offer additional benefits in selected patients over and above exercise in CR.

Cited by 10 publications

References 30 publications

Psychosocial aspects in cardiac rehabilitation: From theory to practice. A position paper from the Cardiac Rehabilitation Section of the European Association of Cardiovascular Prevention and Rehabilitation of the European Society of Cardiology

Psychosocial aspects in cardiac rehabilitation: From theory to practice. A position paper from the Cardiac Rehabilitation Section of the European Association of Cardiovascular Prevention and Rehabilitation of the European Society of Cardiology

Community health service center-based cardiac rehabilitation in patients with coronary heart disease: a prospective study

Psychosocial Aspects in Cardiac Rehabilitation: From Theory to Practice. A Position Paper From the Cardiac Rehabilitation Section of The European Association of Cardiovascular Prevention and Rehabilitation of the European Society of Cardiology

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