Jones D A, West R R
University of Wales College of Medicine, Llandough Hospital, Cardiff.
BMJ. 1996 Dec 14;313(7071):1517-21. doi: 10.1136/bmj.313.7071.1517.
To evaluate rehabilitation after myocardial infarction.
Randomised controlled trial of rehabilitation in unselected myocardial infarction patients in six centres, baseline data being collected on admission and by structured interview (of patients and spouses) shortly after discharge and outcome being assessed by structured interview at six months and clinical examination at 12 months.
Six district general hospitals.
All 2328 eligible patients admitted over two years with confirmed myocardial infarction and discharged home within 28 days.
Rehabilitation programmes comprising psychological therapy, counselling, relaxation training, and stress management training over seven weekly group outpatient sessions for patients and spouses.
Anxiety, depression, quality of life, morbidity, use of medication, and mortality.
At six months there were no significant differences between rehabilitation patients and controls in reported anxiety (prevalence 33%) or depression (19%). Rehabilitation patients reported a lower frequency of angina (median three versus four episodes a week), medication, and physical activity. At 12 months there were no differences in clinical complications, clinical sequelae, or mortality.
Rehabilitation programmes based on psychological therapy, counselling, relaxation training, and stress management seem to offer little objective benefit to patients who have experienced myocardial infarction compared with previous reports of smaller trials.
评估心肌梗死后的康复情况。
在六个中心对未经挑选的心肌梗死患者进行康复的随机对照试验，入院时收集基线数据，并在出院后不久通过（对患者及其配偶的）结构化访谈收集数据，在六个月时通过结构化访谈评估结局，在12个月时进行临床检查。
六家地区综合医院。
两年内所有确诊心肌梗死且在28天内出院回家的2328例符合条件的患者。
康复计划包括为患者及其配偶提供为期七周的每周一次的门诊小组心理治疗、咨询、放松训练和压力管理训练。
焦虑、抑郁、生活质量、发病率、药物使用情况和死亡率。
在六个月时，康复患者与对照组在报告的焦虑（患病率33%）或抑郁（19%）方面无显著差异。康复患者报告的心绞痛发作频率（中位数为每周三次对四次）、药物使用和体力活动较低。在12个月时，临床并发症、临床后遗症或死亡率无差异。
与之前较小规模试验的报告相比，基于心理治疗、咨询、放松训练和压力管理的康复计划对心肌梗死患者似乎没有明显的客观益处。
