The effect of cardiac rehabilitation on anxiety and depression in patients undergoing cardiac bypass graft surgery in Iran

BMC Cardiovascular Disorders

Najaf Zare¹  Javad Kojuri²  Mansour Janati⁴  Alireza Shoul³  Farkhondeh Sharif⁵ 

[1] Department of Biostatistics, Shiraz University of Medical Sciences, Shiraz, Iran;Department of Internal Medicine, Shiraz University of Medical Sciences, Shiraz, Iran;Faghihi Hospital, Cardiac Surgery Unit, Shiraz University of Medical Sciences, Shiraz, Iran;Department of Surgery, Shiraz University of Medical Sciences, Shiraz, Iran;Department of Psychiatric& Mental Health Nursing, Shiraz University of Medical Sciences, Shiraz, Iran

关键词: Rehabilitation;    Depression;    Anxiety;    Coronary artery bypass graft;   

Others  :  1084939
DOI  :  10.1186/1471-2261-12-40

 received in 2011-05-25, accepted in 2012-06-08,  发布年份 2012

【 摘 要 】

Background

Many patients experience anxiety and depression after cardiac bypass surgery.

The aim of this study was to examine the effect of cardiac rehabilitation on anxiety and depression in patients undergoing coronary artery bypass grafting in hospitals affiliated to Shiraz University of Medical Sciences in southern Iran.

Methods

For this randomized controlled trial, 80 patients who met the inclusion criteria were recruited and randomly assigned to case and control groups. Anxiety was measured with the Spielberger Anxiety Scale and depression was measured using Beck’s Depression Inventory at three points in time: on discharge from the hospital, immediately after the intervention, and 2 months after cardiac rehabilitation. After measuring anxiety and depression in both groups upon discharge, the experimental group participated in 8 cardiac rehabilitation sessions over a 4-week period. The control group received only the routine follow-up care.

Results

There was a statistically significant difference in depression scores between groups at all three time-points (Mean score from 19.6 to 10 in the intervention group and from 19.5 to 14 in the control group, P = 0.0014). However, no significant difference was seen in anxiety scores between the groups (Mean score from 37 to 28 in the intervention group and from 38 to 32 in the control group, P = 0.079).

Conclusions

Cardiac rehabilitation was effective in reducing depression 2 months after surgery in patients undergoing coronary artery bypass grafting.

Trial registration

IRCTN201203262812N8

【 授权许可】

   
2012 Sharif et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]Binafar N: Cardio-vascular Diseases. Eshtiagh Publication, Tehran; 1999.
• [2]Briody M: The role of nurses in modification of cardiac risk factors. Nursing Clinics of North American 1988, 19(2):22-26.
• [3]Mohamad Alayha Z: Heart, Vascular and Blood. Shabak, Tehran; 2009.
• [4]Gharib M: Rehabilitation in coronary heart disease. In 12th Cardio-vascular Congress, Tehran; 2001.
• [5]Lie I, Arnesen H, Sandvik L, Hamilton G, Bunch EH: Effects of home based intervention program on anxiety and depression 6 months after coronary artery bypass grafting. J Psychosomatic Res 2007, 62:411-418.
• [6]Serruys PW, Morice MC, Kappetein AP, Colombo A, Holmes DR, Mack MJ, et al.: Percutaneous coronary intervention versus coronary-artery bypass grafting for severe coronary artery disease. N Engl J Med 2009, 360:961-972.
• [7]Afrasiabi Far A, et al.: Participation barriers in myocardial infarction patients in cardiac rehabilitation program. J Rehab 2008, 9(3):75-81.
• [8]Davoud Vand ShM, Elahi N, Ahmadi F, Haghighi Zadeh MH: Effectiveness of the short-term cardiac rehabilitation programs on the rate of disease relapse again refer and rehospitalization in patients with myocardial infarction (Persian). J Rehab 2008, 9(1):17-22.
• [9]Zare Z, et al.: The effect of touch therapy on patient’s anxiety before cardiac bypass surgery [Abstract]. In: Cardio-vascular Congress, Tehran; 2008:187-190.
• [10]Rymaszewska J, Kiejna A, Hadrys T: Depression and anxiety in coronary artery bypass grafting patients. Eur Psychiatry 2003, 18(4):155-160.
• [11]Crowe JM, Runions J, Ebbesen LS, Oldridge NB, Streiner DL: Anxiety and depression after acute myocardial infarction. Heart Lung 1996, 25:98-107.
• [12]Hambridge JA, Turner A, Baker AL: Brave Heart begins. Aust N Z J Psychiatry 2009, 43(12):1171-1177.
• [13]Nemeroff C: Prevalence of depression and anxiety in CABG patients. Journal Watch psychiatry 2003, 18:12-19.
• [14]Gallagher R, Mckinley S: Anxiety, depression and perceived control in patients having coronary artery bypass grafts. J Adv Nurs 2009, 65(11):2386-2396.
• [15]Giannuzzi P, Saner H, Bjo rnstad H, Fioretti P, Mendes M, Cohensolal A, et al.: Secondary prevention through cardiac rehabilitation: European Society of Cardiology. Eur Heart J 2003, 24(13):1273-1278.
• [16]Tod AM, Lacey EA, Mc Neill F: I’m still waiting: barriers to accessing cardiac rehabilitation services. J Adv Nurs 2002, 40(4):421-431.
• [17]McGrady A, McGinnis R, Badenhop D, Bentle M, Rajput M: Effects of depression and anxiety on adherence to cardiac rehabilitation. J Cardiopulm Rehabil Prev 2009, 29(6):358-364.
• [18]Milani RV, Lavie CJ, Cassidy MM: Effects of cardiac rehabilitation and exercise training programs on depression in patients after major coronary events. Am Heart J 1996, 132(4):726-732.
• [19]Clark AM, McAlster FA Hartling L Vandermeer B: Meta-analysis secondary prevention program for CAD database. Syst Rev 2005, 43(1):659-672.
• [20]Taylor-Piliae RE: The effect of nursing intervention utilizing music therapy or sensory information on Chinese patients anxiety prior to cardiac catheterization. Eur J Cardiovasc Nurs 2002, 1(3):69-73.
• [21]Lin Ku, Hung Ku, Chi Ma: Effect of phase I cardiac rehabilitation on anxiety of patients hospitalized for coronary artery bypass graft in Taiwan. Heart Lung 2002, 31:133-140.
• [22]Mayou RA, Gill D, et al.: Depression and anxiety predictors of outcome after myocardial infarction. Psychosom Med 2000, 62(2):212-219.
• [23]Hazavehei SM, et al.: The effect of precede Model-based educational program on depression level in patients with coronary artery bypass grafting. Journal of Qazvin University of Medical Sciences 2008, 12(2):32-40.
• [24]Rymazewska J, Kiejna A: Depression and anxiety after coronary artery bypass grafting. Pol Merkur Lekarski 2003, 15(86):193-195.
• [25]Aghamohammadi M, Karimollahi M: Religiousness and preoperative anxiety: a correlational study. Ann Gen Psychiatr 2007, 6(17):1-5.
• [26]Ghassemzadeh H, Mojtabai R, Rearamghadisi N, Ebrahimkhani N: Psychometric properties of a Persian-language version of the Beck depression inventory: Second edition. Journal of Depression and Anxiety 2005, 21(4):185-192.
• [27]Dehdari T, Heidarnia A, Ramezankhani A, Sadeghian S, Ghofranipour F: Effects of progressive muscular relaxation training on quality of life in anxious patients after coronary artery bypass graft surgery. Indian J Med Res 2009, 129(5):603-608.
• [28]Seki E, Watanabe Y, Sunuyama S, et al.: Effect of phase 3 cardiac rehabilitation program on health artery disease. Circ Journal 2003, 67:73-77.
• [29]Dugmore L, Tipson R, Phillips M, Flint E, Stentiford N, Bone M, Littler W: Changes in cardiorespiratory fitness, psychological wellbeing, quality of life, and vocational status following a 12 month cardiac exercise rehabilitation programme. Heart 1999, 81:359-366.
• [30]Dehdari T, Heidarnia A, Ramezankhani A, Sadeghian S, Ghofranipour F, Babaei G, et al.: Effects of phase III cardiac rehabilitation programs on anxiety and quality of life in anxious patients after coronary artery bypass surgery. J The Univ Heart Ctr 2007, 4:207-212.
• [31]Yoshida T, Kohzuki M, Yoshida K, Hiwatari M, et al.: Physical and psychological improvements after phase 2 cardiac rehabilitation in patients with myocardial infarction. Nurs Health Sci 2002, 1(3):163-170.
• [32]Mohamadi F, Taherian A, Hosseini MA, Rahgozar M: Effect of home-based cardiac rehabilitation in home on quality of life in the patients with myocardial infarction (Persian). J Rehabil 2006, 7(3):11-19.
• [33]Jolly K, Lip GYK, Taylor RS, Raftery J, Mant J, Lane D, et al.: The Birmingham rehabilitation uptake andomizedn study (BRUM): a randomized controlled trial comparing home-based with centre-based cardiac rehabilitation. Heart 2009, 95:36-42.