The long-term benefits of cardiac rehabilitation on depression, anxiety, physical activity and quality of life.

Aims. To investigate the long-term benefits of a six-week comprehensive cardiac rehabilitation programme on physical activity, psychological well-being and quality of life in patients with coronary heart disease. Background. Cardiac rehabilitation (CR) in short term improves exercise capacity and quality of life in patients with cardiac disease. However, the long-term benefits of CR are inconclusive. Design. A prospective CR programme with repeated measures follow-up over 12 months. Methods. A six-week outpatient cardiac rehabilitation programme was conducted including 147 patients with coronary heart disease. Patients completed the physical activity energy expenditure (seven-day recall activity), MacNew Heart Disease Health-Related Quality of Life (MacNew) and Hospital Anxiety and Depression scale (HADs) at baseline, six weeks, six and 12 months. Results. One hundred and five (71%) patients (76 male) mean age of 61·8 (SD 9·7) completed the four-measurement points. Analysis of variance revealed that total energy expenditure ( F (2, 231) = 131, p < 0·001), HADs ( F (2, 237) = 19·3, p < 0·001), depression score ( F (2, 235) = 21·06, p < 0·001), anxiety score ( F (2,237) = 17·02, p < 0·001) and MacNew ( F (2, 197) = 77·02, p < 0·001) were all statistically significant over time. Bonferroni pairwise follow-up confirmed significant positive differences ( p < 0·05) between baseline values and all subsequent measures over time. Depression was independently explained in 22% of the variance in quality of life at 6 or 12 months. The energy expenditure was significantly higher for men compared to women ( F (1, 103) = 31, p < 0·001). Conclusion. A six-week cardiac rehabilitation programme is beneficial in improving quality of life, physical activity status, anxiety and depression. These benefits were maintained at 12 months. Elevated levels of depression were associated with impaired quality of life. Relevance to clinical practice. All relevant health care staff should be aware of the benefits of CR and routinely refer and encourage patients with cardiac disease to attend a cardiac rehabilitation programme. Depression and anxiety intervention strategies should be incorporated in cardiac rehabilitation programmes. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Clinical Nursing (John Wiley & Sons, Inc.) is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)