Department of Psychiatry, The University of Toledo, Health Science Campus, Mail Stop #1193, Toledo, OH 43614, USA.
J Cardiopulm Rehabil Prev. 2009 Nov-Dec;29(6):358-64. doi: 10.1097/HCR.0b013e3181be7a8f.
To determine the effects of depression and anxiety on patient completion of structured cardiac rehabilitation.
Retrospective chart review of 380 patients with myocardial infarction, coronary artery bypass graft, angina, or chronic heart failure referred to cardiac rehabilitation. Patient physical capacity was tested by the standard 12-minute walk test (WT). Depression, anxiety, and quality of life were assessed by standard questionnaires. Program completers were contrasted to dropouts on dependent variables at baseline. Baseline and postprogram WT, depression, anxiety, and quality of life were also compared in completers by using ANOVA and paired t tests.
One-half of entering patients completed the program. Statistically significant differences were observed in baseline depression, anxiety, and quality of life between program completers and dropouts. Dropouts had higher depression and anxiety scores and lower quality of life, but there were no differences in WT. Younger, female patients had higher dropout rates. Women also had higher psychological distress, lower quality of life, and less feet walked than men. Dropout rate was lowest in patients with coronary artery bypass graft and highest in patients with chronic heart failure. Both male and female completers evidenced significant improvements in WT, depression, anxiety, and quality of life.
Psychological distress makes completion of cardiac rehabilitation difficult. Patients need to be assessed early in the intervention so that depression and anxiety can be identified and managed. Completion of the program is advantageous because it is associated with improvement in all measured variables.
确定抑郁和焦虑对患者完成结构性心脏康复的影响。
对 380 名心肌梗死、冠状动脉旁路移植术、心绞痛或慢性心力衰竭患者进行回顾性图表审查，这些患者均被转诊至心脏康复机构。患者的身体能力通过标准的 12 分钟步行测试（WT）进行测试。通过标准问卷评估抑郁、焦虑和生活质量。将基线时的依赖变量与康复计划的完成者和辍学者进行对比。还通过方差分析和配对 t 检验比较完成者的基线和计划后 WT、抑郁、焦虑和生活质量。
有一半进入该计划的患者完成了该计划。在计划完成者和辍学者之间，基线时的抑郁、焦虑和生活质量存在显著差异。辍学者的抑郁和焦虑评分更高，生活质量更低，但 WT 没有差异。年轻、女性患者的辍学率更高。女性的心理困扰、生活质量和行走的脚步也比男性少。冠状动脉旁路移植术患者的辍学率最低，慢性心力衰竭患者的辍学率最高。男性和女性完成者的 WT、抑郁、焦虑和生活质量均有显著改善。
心理困扰使得心脏康复的完成变得困难。患者需要在干预早期进行评估，以便识别和管理抑郁和焦虑。完成该计划是有利的，因为它与所有测量变量的改善相关。
