Denollet J, Brutsaert D L
Center of Cardiac Rehabilitation, University of Antwerp, Belgium.
Eur Heart J. 1995 Aug;16(8):1070-8. doi: 10.1093/oxfordjournals.eurheartj.a061049.
Since emotional distress is linked to poor prognosis in coronary patients, there is urgent need for research into interventions that may enhance emotional well-being in these patients. Cardiac rehabilitation aims to return the individual to optimal emotional function, but the psychological effect of this therapy still needs to be demonstrated. Hence, we examined the role of cardiac rehabilitation in enhancing emotional health. We examined 170 male patients with coronary heart disease, of whom 85 had participated in the outpatient rehabilitation programme of the University Hospital of Antwerp and 85 had received standard medical care only in two other hospitals. Rehabilitation and control patients were matched by medical category and tendency to experience distress. The Global Mood Scale, the Health Complaints Scale, and the Heart Patients Psychological Questionnaire were used to assess changes in emotional well-being over a 3-month period. These changes were significantly different as a function of cardiac rehabilitation (P<0.0001). Rehabilitation patients, but not control patients, reported a significant improvement in negative affect, positive affect, well-being , health and disability (P<0.001). At follow-up, differences in depression, tranquillizer use (P<0.05), and activity profile (P<0.01) confirmed that rehabilitation patients displayed more healthy behaviour than control patients. Patients not only improved more, but also deteriorated less as a function of rehabilitation. This therapy also had a positive effect on patients suffering minimal distress, which is at variance with previous research. These findings suggest that comprehensive rehabilitation may be an effective therapy for enhancing emotional well-being in patients with coronary heart disease.
由于情绪困扰与冠心病患者的不良预后相关，因此迫切需要研究能够改善这些患者情绪健康的干预措施。心脏康复旨在使个体恢复到最佳情绪功能状态，但这种疗法的心理效果仍有待证实。因此，我们研究了心脏康复在改善情绪健康方面的作用。我们对170名男性冠心病患者进行了研究，其中85人参加了安特卫普大学医院的门诊康复项目，另外85人仅在其他两家医院接受了标准医疗护理。康复组和对照组患者在医疗类别和情绪困扰倾向方面进行了匹配。使用全球情绪量表、健康投诉量表和心脏病患者心理问卷来评估3个月期间情绪健康的变化。这些变化因心脏康复而有显著差异（P<0.0001）。康复组患者而非对照组患者在消极情绪、积极情绪、幸福感、健康状况和残疾方面有显著改善（P<0.001）。在随访中，抑郁、镇静剂使用情况（P<0.05）和活动情况（P<0.01）的差异证实，康复组患者比对照组患者表现出更健康的行为。患者不仅改善得更多，而且因康复而恶化的程度更小。这种疗法对痛苦最小的患者也有积极影响，这与先前的研究不同。这些发现表明，综合康复可能是改善冠心病患者情绪健康的有效疗法。
