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Cardiac rehabilitation: the role of psychological intervention

Published online by Cambridge University Press:  13 June 2014

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A coronary event has major psychological, as well as physical, consequences. The recent British Cardiac Society's Working Party Report on Cardiac Rehabilitation acknowledges the importance of comprehensive rehabilitation programmes incorporating a psychological input. Psychological intervention as part of cardiac rehabilitation serves two purposes: to maximise psychosocial recovery, including return to customary activities such as work and sexual relationships, and to facilitate the secondary prevention of coronary heart disease. The latter involves providing behavioural change strategies for a range of lifestyle factors from stress identification and management, through dietary, smoking and physical activity change, to increasing adherence to medication regimes.

Psychological interventions have proven successful in decreasing general morbidity in the year after coronary events and in reducing reinfarction-related mortality. Little is understood about the mechanisms by which psychological interventions may operate. However, a recent seminal study of intensive lifestyle modification in cardiac patients has demonstrated that it is possible to achieve regression of atherosclerosis (although the authors themselves caution that their intensive methods are unlikely to be applicable in most patient settings). More general discussion of the relationship between psychological factors and coronary disease is available. With regard to enhancement of psychosocial recovery, early work documented positive effects of exercise-only programmes on psychosocial functioning.

Type
Editorial
Copyright
Copyright © Cambridge University Press 1994

References

1.Horgan, JH, Bethell, H, Carson, P, Davidson, C, Julian, D, Mayou, RA, Nagle, R. British Cardiac Society Working Party Report on cardiac rehabilitation. Br Heart J 1992; 67:412–8.CrossRefGoogle Scholar
2.Langosch, W, Seer, P, Brodner, G, Kallinke, D, Kulice, B, Helm, P. Behaviour therapy with coronary heart disease patients: results of a comparative study. J Psychosom Res 1982; 10: 129.Google Scholar
3.Friedman, H, Thoresen, CE, Gill, JJ, et al.Alteration of type A behaviour and its effect on cardiac recurrences in postmyocardial infarction patients: summary results of the Recurrent Coronary Prevention Project. Am Heart J 1986; 112: 653–65.CrossRefGoogle Scholar
4.Frasure-Smith, N, Prince, R. The Ischemic Heart Disease Life Stress Monitoring Program: impact on mortality. Psychom Med 1985; 47: 431–45.CrossRefGoogle ScholarPubMed
5.Ornish, D, Brown, SE, Schwerwitz, LW, et al.Can lifestyle changes reverse coronary heart disease? Lancet 1990; 336: 129–33.CrossRefGoogle ScholarPubMed
6.McGee, HM, Graham, T, Horgan, JH, (Eds). Heart disease: the psychological challenge. Ir J Psychol 1994; 15:1.CrossRefGoogle Scholar
7.Prosser, G, Carson, P, Comoss, P, et al.Morale in coronary patients following an exercise programme. J Psychosom Res 1981; 25: 587–93.CrossRefGoogle ScholarPubMed
8.Leon, AS, Certo, C, Comoss, Pet al.Scientific evidence of the value of cardiac rehabilitation services with emphasis on patients following myocardial infarction – section I: exercise conditioning component. J Cardiopulm Rehab 1990; 10: 7987.CrossRefGoogle Scholar
9.O'Connor, GT, Buring, JE, Yusuf, S, et al.An overview of randomised trials of rehabilitation with exercise after myocardial infarction. Circulation 1989; 80:234–44CrossRefGoogle ScholarPubMed
10.van Dixhoorn, J, Duivenvoorden, HJ, Staal, HA. Physical training and relaxation therapy in cardiac rehabilitation assessed through a composite criteria for training outcome. Am Heart J 1989; 118: 545–52.CrossRefGoogle Scholar
11.van Dixhoorn, J, Duivenvoorden, HJ, Staal, JA, Poolj, , Verhage, F. Cardiac events after myocardial infarction: possible effect of relaxation therapy. Eur Heart J 1987; 8: 1210–4.CrossRefGoogle ScholarPubMed
12.Maes, S. Psychosocial aspects of cardiac rehabilitation in Europe. Br J Clin Psychol 1992; 31: 473–83.CrossRefGoogle ScholarPubMed
13.Dracup, K, Meleis, A, Baker, K, Edlefsen, P. Family-focused cardiac rehabilitation – a role supplement programme for cardiac patients and spouses. Nurs Clin North Am 1984; 19: 113–24.CrossRefGoogle Scholar
14.McGee, HM, Horgan, JH. Cardiac rehabilitation programmes: are women less likely to attend? BMJ 1992; 305: 283–4.CrossRefGoogle ScholarPubMed
15.Oldridge, N, Guyatt, G, Jones, N, et al.Effects on quality of life with comprehensive rehabilitation after acute myocardial infarction. Am J Cardiol 1991; 67: 1084–9.CrossRefGoogle ScholarPubMed
16.Lewin, B, Robertson, IH, Cay, EL, Irving, JB, Campbell, M. Effects of self-help post myocardial infarction rehabilitation on psychological adjustment and use of health services. Lancet 1992; 339: 1036–40.CrossRefGoogle ScholarPubMed
17.Blumenthal, JA, Williams, RS, Wallace, AG, William, RB, Needles, TL. Physiological and psychological variables predict compliance to prescribed exercise therapy in patients recovering from myocardial infarction. Psychosom Med 1982; 44: 519–27.CrossRefGoogle ScholarPubMed
18.Siddiqui, HA. Cardiac rehabilitation and elderly patients. Age & Ageing 1992; 21: 157–9.CrossRefGoogle Scholar
19.Coats, AJS, Adamopoulos, S, Meyer, TE, Conway, J, Sleight, P. Effects of physical training in chronic heart failure. Lancet 1990; 335: 63–6.CrossRefGoogle ScholarPubMed
20.Oldridge, N, Furlong, W, Feeing, D, et al.Economic evaluation of cardiac rehabilitation soon after myocardial infarction. Am J Cardiol 1993; 72: 154–61.CrossRefGoogle Scholar
21.Levin, L, Perk, J, Hedback, B. Cardiac rehabilitation – a cost analysis. J Int Med 1991; 230: 427–35.CrossRefGoogle ScholarPubMed