The measure of effectiveness of a short-term 2-week intensive Cardiac Rehabilitation program in decreasing levels of anxiety and depression

Abstract

Research on heart disease have found a strong and consistent evidence of association between some psychosocial risk factors, including depression, anxiety, self-efficacy, lack of social support and outcome of disease. Depression increases the risk of cardiac death and is highly predictive of reduced adherence to recommended treatments; anxiety appears to be linked to adverse cardiac outcomes. It was demonstrated that Cardiac Rehabilitation (CR) leads to substantial improvements and positive outcomes because combines the prescription of physical activity with the modification of risk factors and aims to reduce symptoms related to the disease and the risk of new cardiovascular events. The main objective of this study is to determine if a short and intense CR program can produce a positive impact on anxious and depressive symptoms revealed in cardiac patients, confirming results of previous researches. The protocol was proposed to all patients referred for an outpatient CR after an acute event who attended the short 2-week intensive rehabilitation program. A total of 157 patients recruited at the operating unit of Cardiology, in the Hospital of Cittadella (Italy), was included in the analysis. The Beck Depression Inventory-II and the State-Trait Anxiety Inventory-Y were administered to the patients. SPSS 17.0 was used for statistical analysis. T-tests for paired samples were used to evaluate differences between the beginning and the end of the CR program. There was a statistically significant difference between the beginning and the end of the CR program. Results for paired samples showed significant differences in all factors of the BDI-II and in the total score. In addition, a statistically significant difference was found even in the state - anxiety subscale. No significant difference was detected for the trait anxiety. According to recent studies, this research shows that the CR program has a significant impact on levels of anxiety and depression, because all activities focus their commitment on changing the patient's personal beliefs and perception of illness, promoting the exchange of information and sharing of concerns and fears, increasing the patient's resilience with the aim of enabling him/her to reorganize positively his/her personal, family and professional sphere.

The perception of the illness and the self-efficacy in the management of emotions in cardiac patients

“…The psychotherapist has a specific training on group psychotherapy and on the management of groups of patients with physical diseases, in addition to the therapist there are also a nurse and a trainee psychologist. The psychological support group offers patients a space dedicated to reflection on their own disease, allowing them to share their deepest anxieties and to understand how to live with the disease (Caccamo et al, 2018 ). During the group meetings, patients meet other patients who lived similar experiences and this increases the perception of social support and the reassurance that comes with it (Yalom & Leszcz, 2005 ).…”

“…Recent studies show the effectiveness of psychological support group treatment in cardiac patients (Caccamo et al, 2018 ). Group treatment not only allows sharing problems, including interpersonal conflicts, life transitions concerns and grief but it also addresses social isolation, a factor that was associated with an increased mortality and morbidity in some studies of patients with post-acute or chronic heart disease (Rutledge, Redwine, Linke, & Mills, 2013 ).…”

Physical and Psychological Outcomes of Patients Undergoing Traditional Cardiac Rehabilitation and Intensive Cardiac Rehabilitation

“…Our study showed that ICR performs better than TCR for psychological health and weight loss, which can be attributed to ICR robust nonexercise components, such as a plant-based diet, relaxation techniques as well as emotional support of 1-hr each twice a week for 9 wk 2,27. Conversely, TCR patients achieved higher improvement in CRF compared with ICR patients, which is important as each MET improvement is associated with >10% reduction in long-term mortality risk 16,28–31.…”

Effectiveness of Mindfulness and Positive Strengthening mHealth Interventions for the Promotion of Subjective Emotional Wellbeing and Management of Self-Efficacy for Chronic Cardiac Diseases

“…Nonetheless, given that this was a feasibility study, future research with a larger number of participants and with full randomization to the experimental and control conditions should replicate the proposed design to test if further support can be provided to the results obtained. Given that rehabilitation interventions with social support have been found to be very helpful for cardiac patients [63] and could be carried out in a group format, we hypothesize that the efficacy of interventions developed in any future study would be stronger in a group format than in an individual format.…”