Bermudez Tania, Bierbauer Walter, Scholz Urte, Hermann Matthias
Applied Social and Health Psychology Unit, Department of Psychology, University of Zurich, Zurich, Switzerland.
University Research Priority Program "Dynamics of Healthy Aging", University of Zurich, Zurich, Switzerland.
Anxiety Stress Coping. 2022 Mar;35(2):204-218. doi: 10.1080/10615806.2021.1952191. Epub 2021 Jul 16.
Cardiac rehabilitation (CR) has been successful in improving exercise capacity (EC) and quality of life (QoL). However, depression and anxiety are highly prevalent among cardiac patients and might represent risk factors for rehabilitation outcomes. The aim of this study was to investigate the role of depression and anxiety as possible independent risk factors for CR outcomes.
The study applied a pre-post-design. The sample comprised = 3'434 cardiac disease patients taking part in a Swiss inpatient CR center. Variables measured at the beginning (T1) and end of rehabilitation (T2) included depression and anxiety (HADS), EC, and QoL (MacNew). A path analysis was conducted.
Depression at T1 had a significant negative relationship with improvements in EC and in all aspects of QoL during rehabilitation. Anxiety at T1 was positively related to improvements in EC and in emotional and physical QoL. Improvements in depression during CR were positively related with improvements in all outcomes. Improvements in anxiety showed no significant association with the outcomes.
Depression and anxiety should be screened for during CR. Depression should be treated due to the negative association found with rehabilitation outcomes. Underlying mechanisms of the positive association of anxiety with rehabilitation outcomes need further investigation.
心脏康复（CR）已成功改善运动能力（EC）和生活质量（QoL）。然而，抑郁症和焦虑症在心脏病患者中非常普遍，可能是康复结果的危险因素。本研究的目的是调查抑郁症和焦虑症作为CR结果可能的独立危险因素的作用。
本研究采用前后设计。样本包括3434名参与瑞士住院CR中心的心脏病患者。在康复开始时（T1）和结束时（T2）测量的变量包括抑郁和焦虑（医院焦虑抑郁量表）、运动能力和生活质量（MacNew量表）。进行了路径分析。
T1时的抑郁与康复期间运动能力和生活质量各方面的改善呈显著负相关。T1时的焦虑与运动能力以及情绪和身体生活质量的改善呈正相关。CR期间抑郁的改善与所有结果的改善呈正相关。焦虑的改善与结果无显著关联。
在CR期间应筛查抑郁和焦虑。由于发现抑郁与康复结果呈负相关，因此应进行治疗。焦虑与康复结果呈正相关的潜在机制需要进一步研究。
