Sensitivity of outcome assessment in cardiac rehabilitation.

I hypothesized that measures that match the theoretically prescribed effect of cardiac rehabilitation (i.e., enhancement of subjective health and well-being) are more appropriate to assess change than are measures of psychopathology. Study 1 examined the differential sensitivity to change of 3 measures in a sample of 162 men with coronary heart disease (CHD) who participated in cardiac rehabilitation. Ss reported less change on the State-Trait Anxiety Inventory and the Symptom Check List than on the Heart Patients Psychological Questionnaire, but in the absence of a control group it is difficult to known what caused this change. In Study 2, 60 men with CHD who participated in rehabilitation were compared with 60 men with CHD who received standard medical care alone. Rehabilitation Ss, but not control Ss, reported a decrease in disability and an increase in well-being as measured by the HPPQ. I concluded that sensitive measures may actually provide evidence for the psychological effect of cardiac rehabilitation.