Effect of Intense Lifestyle Modification and Cardiac Rehabilitation on Psychosocial Cardiovascular Disease Risk Factors and Quality of Life

Aldana, Steven G.; Whitmer, William R; Greenlaw, Roger L.; Avins, Andrew L.; Thomas, D.; Salberg, Audrey; Greenwell, Andrea; Lipsenthal, Lee; Fellingham, Gilbert W.

doi:10.1177/0145445504267797

Cited by 29 publications

(20 citation statements)

References 19 publications

(26 reference statements)

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“…Many previously published studies demonstrate an improvement in QOL after CR in patients with cardiovascular diseases, although the results came from different models of CR programs (home-based, hospital-based and ambulatory) and different groups of patients. [12][13][14][15][16][17][18][19][20][21][22][23][39][40][41] An improvement in the exercise capacity of CR patients as a result of physical activity similar to our results was also observed in previous studies. 3,5,44,45 We found no correlation between increasing exercise capacity and the improvement in health-related QOL according to EQ-5D and SF36.…”

Section: Discussionsupporting

confidence: 91%

“…Many published studies have revealed improvements in the health-related QOL of patients with CHD after CR programs, either the residential model or ambulatory CR (ACR). [12][13][14][15][16][17][18][19][20][21][22][23] The aim of this study was to evaluate the impact of different models of CR, residential vs ambulatory, on healthrelated QOL according to the exercise capacity of patients with CHD. …”

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confidence: 99%

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Health-Related Quality of Life in Patients With Coronary Heart Disease After Residential vs Ambulatory Cardiac Rehabilitation

Jegier¹,

Szmigielska²,

Bilińska³

et al. 2009

Circ J

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he number of people who survive myocardial infarction or undergo percutaneous coronary intervention (PCI) or coronary artery bypass graft surgery (CABG) is growing. These people require adequate treatment and care not only pharmacologically but also nonpharmacologically: physiotherapeutic, psychological and educational. Comprehensive cardiac rehabilitation (CR) is designed to support patients with coronary heart disease (CHD) in their physical, psychological and emotional recovery after acute coronary events and to help them change lifestyle and risk factors, as well as to make their lives longer and improve their quality.Most published studies analyzing the effects of CR have revealed a reduction in total mortality by an average of 30% and cardiovascular mortality by an average of 40% [1][2][3][4][5][6][7][8][9][10] and also reduction in cardiovascular events risk. 1,4,11 Recently, not only mortality and morbidity but also healthrelated quality of life (QOL) has become a key goal for patients with CHD. Many published studies have revealed improvements in the health-related QOL of patients with CHD after CR programs, either the residential model or ambulatory CR (ACR). [12][13][14][15][16][17][18][19][20][21][22][23] The aim of this study was to evaluate the impact of different models of CR, residential vs ambulatory, on healthrelated QOL according to the exercise capacity of patients with CHD. MethodsThis study was designed as a nonrandomized prospective multicenter study in Poland: the National Program of Prevention and Therapy of Cardiovascular Diseases (POLKARD). We studied 562 patients with CHD from 9 centers of CR in Poland. Consecutive patients were referred to 3 ACR and 6 residential CR (RCR) centers no longer than 2 weeks after myocardial infarction or PCI, and no longer than 6 weeks after CABG.The reason for the choice of ACR or RCR center was not the patient's clinical state or risk profile for cardiovascular events, but which type of CR was available where the patient lived. Therefore, randomization in our study was impossible.The first group consisted of 313 patients aged 56.1±8.8 (Received April 24, 2008; revised manuscript received October 8, 2008; accepted October 26, 2008; released online January 29, 2009) Background: The aim of this study was to evaluate the influence of residential (RCR) vs ambulatory (ACR) cardiac rehabilitation (CR) on health-related quality of life (QOL) connected with changes in exercise capacity of patients with coronary heart disease (CHD). Methods and Results:The 562 patients with CHD were studied: 313 participants in RCR and 249 participants in ACR. The examination was performed at the beginning of CR and after 8 weeks. QOL was assessed using the EuroQuol 5D (EQ-5D) and SF36 questionnaires. Exercise testing was performed with evaluation of workload during the last stage of the test and rate of perceived exertion intensity. In the first examination, patients from both groups did not differ significantly. After 8 weeks, a similar improvement in QOL was observed in bo...

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Section: Discussionsupporting

confidence: 91%

mentioning

confidence: 99%

Health-Related Quality of Life in Patients With Coronary Heart Disease After Residential vs Ambulatory Cardiac Rehabilitation

Jegier¹,

Szmigielska²,

Bilińska³

et al. 2009

Circ J

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“…Thirty years of data support this approach. 13,14 Some researchers have already noted that natural compounds from plants "address whole mechanisms, sets of pathways that interfere with tumors rather than single enzyme inhibition accomplished through use of cytotoxic drugs.…”

Section: Active Constituentsmentioning

confidence: 99%

Patient Perspectives: Barriers to Complementary and Alternative Medicine Therapies Create Problems for Patients and Survivors

Fonfa

2007

Integr Cancer Ther

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There are multiple barriers to better understanding of complementary and alternative medicine (CAM) approaches and the use of natural substances to reduce cancer risk. CAM approaches are not patentable, and the pharmaceutical industry has no interest in the area. Research generally approaches concepts from the deconstructionist side: there may be interest in herbal mixtures but its "active" constituents are explored one at a time, missing any synergistic or even additive effects. Little attention has been paid to environmental pollutants and exposures. Most patients believe these are active causes of their disease, but researchers are still exposing animals to one chemical one time, which fails to duplicate human exposures. Attention to lifestyle issues is presented almost solely in terms of obesity⎯ ⎯a concept that is a barrier to change by itself. Research animals rarely if ever are fed dietary components that humans normally eat, such as soda or diet soda, potato chips, and high-fructose corn syrup, artificial colors, artificial flavors, other additives, or combinations of bad fats with too much sugar, too much salt, and artificial ingredients. Long-term treatment effects on survivors may not necessarily require a solely pharmaceutical approach. Drugs to treat each condition separately may require even more drugs to offset the unwanted effects of each. Whole systems approaches to research are urgently needed. A final barrier is that once a treatment is accepted in mainstream, it ceases to be considered "alternative." The genesis is soon forgotten and the remaining alternative modalities continue to be viewed with suspicion, doubt, and misunderstanding, to the detriment of both patients in treatment and cancer survivors.

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“…(23) Studies report that social support is a facilitating factor for coping with the disease and in the recovery of cardiac patients, suggesting that patient participation in rehabilitation activities improves the psychosocial aspects and the Quality of Life. (24) However, health professionals can use assessments in social support in order to detect individuals who will have greater difficulties in rehabilitation, since this may influence the need of changing to a behavior conducive to cardiovascular health. (23) Regarding risk factors, these were similar to those observed in other studies.…”

Section: Discussionmentioning

confidence: 99%

Qualidade de Vida de pacientes submetidos à revascularização do miocárdio

Boni¹,

Martinez

Saccomann

2013

Acta paul. enferm.

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Objective: Determining the impact of coronary artery bypass grafting on the Quality of Life of patients, analyzing and comparing dimensions of Quality of Life before and after surgery; comparing sociodemographic and clinical variables with the aspects of depression and anxiety, in the pre and postoperative periods. Methods: A descriptive exploratory study in which 78 patients were included in the pre and postoperative periods. International instruments of research were used and validated to assess quality of life and the aspects of depression and anxiety. Results: There was significant improvement in all domains of the Quality of Life, depression and anxiety (p=0.05). The physical and social domains of the 36-Item Short-Form Health Survey showed lower scores (13.46 and 3.03, respectively), as well as the social domain of the Macnew instrument (3.03). Conclusion: Coronary artery bypass surgery caused positive impact on the Quality of Life of these patients. ResumoObjetivo: Determinar o impacto da cirurgia de revascularização do miocárdio na Qualidade de Vida dos pacientes; analisar e comparar dimensões da Qualidade de Vida antes e após a intervenção cirúrgica; comparar variáveis sociodemográficas e clínicas aos aspectos de depressão e ansiedade, pré e pós-operatórios. Métodos: Estudo descritivo exploratório no qual foram incluídos 78 pacientes no pré e pós-operatório. Foram utilizados instrumentos de pesquisa internacionais e validados para avaliar a qualidade de vida e os aspectos de depressão e ansiedade. Resultados: Houve melhora significativa em todos os domínios da Qualidade de Vida, depressão e ansiedade (p=0,05). Domínios físico e social do 36-Item Short-Form Health Survey apresentaram menor pontuação dos escores (13,46 e 3,03, respectivamente), bem como o domínio social do instrumento Macnew (3,03). Conclusão: Cirurgia de revascularização ocasionou impacto positivo na Qualidade de Vida desses pacientes.

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Effect of Intense Lifestyle Modification and Cardiac Rehabilitation on Psychosocial Cardiovascular Disease Risk Factors and Quality of Life

Cited by 29 publications

References 19 publications

Health-Related Quality of Life in Patients With Coronary Heart Disease After Residential vs Ambulatory Cardiac Rehabilitation

Health-Related Quality of Life in Patients With Coronary Heart Disease After Residential vs Ambulatory Cardiac Rehabilitation

Patient Perspectives: Barriers to Complementary and Alternative Medicine Therapies Create Problems for Patients and Survivors

Qualidade de Vida de pacientes submetidos à revascularização do miocárdio

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