1Instructor of Nursing, department of medical-surgical nursing, school of nursing and midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
2MS in Intensive Care Nursing Student, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
3Phd candidate in Nursing, department of medical-surgical nursing, school of nursing and midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
4Cardiac Surgery specialist, department of Cardiac Surgery, Razavi hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
Background: Anxiety and depression are the most common complications after coronary artery bypass surgery. Although patients may gain some physical and psychological benefit from cardiac rehabilitation after cardiac surgery, but some individuals and social aspects may change the cardiac rehabilitation procedure. Aim: The aim of this study was to determine the effect of short-term cardiac rehabilitation on anxiety and depression in patients after coronary artery bypass surgery. Methods: In this quasi-experimental pretest – post test design study, all patients undergoing coronary artery bypass surgery in Razavi hospital in Mashhad (1392) were participated and for sampling, 70 patients allocated into experimental and control groups by non-randomly convenient method. Subjects in an experimental group received 4-week (10 sessions) cardiac rehabilitation program, while control group received only routine post discharge care. Data was collected using demographic form, social support questionnaire and the Hospital Anxiety and Depression Scale in both groups. Content validity method and Cronbach’s alpha reliability were used. Data were analyzed using statistical test Chi-square, Mann-Whitney, and independed t-test and paired t-test. Results: Themean age of participants was 57.3±8.0 years old, which 70% of them were male.According to the t-test, before the intervention, there was no significant difference between two groups in anxiety and depression mean score, and two groups were equal in background and confounding variables. After the intervention, according to the t-test, mean score for anxiety in rehabilitation group (8.8±3.1) was significantly (P= 0.031) lower than the control group (14±3.9), and mean score for depression in rehabilitation group (7.8±2.9) was significantly (P=0.001) lower than the control group (14.5±3.2). Conclusion: Short-term cardiac rehabilitation program is effective in reducing anxiety and depression in patients after coronary artery bypass surgery. It may be used in care planning, patient education and encouragement for rehabilitation after cardiac surgery.
Black JM, Hawks JH. Medical-Surgical Nursing: Clinical Management for Positive Outcomes.8th ed. Philadelphia: St Louis, Saunders. 2009
Fayyazi S, Shariati A, Momeni M. Review of Benson’s Relaxation Technique Pain after Coronary Artery Bypass Graft Surgery. Scientific Med J. 2008; 8(4): 2-10. (Persian)
Hansen MS, Fink P, Frydenberg M, Sondergaard L, Oxhoj ML, Munk-Jorgensen P. Mental Disorders Among Internal Medical Inpatients: Prevalence, Detection and Treatment Status. J Psychosom Res. 2001; 50(40):199-204.
Rohafzah HR, Saeidi M, Sadeghi M, Boshtam M, Rabiei K. Effect of Cardiac Rehabilitation on Psychological Stresses in an Iranian Population. Research in Medical Science Journal, 2003; 8(3): 94-7 (Persian)
Lie I, Arnesen H, Sandvik L, Hamilton G, Bunch EH. Effects of Home Based Intervention Program on Anxiety and Depression Six Months after Coronary Artery Bypass Grafting. J Psychosom Res. 2007; 62(4): 411-8.
Zare Z. The Effect of Touch Therapy on Patient’s Anxiety before Cardiac Bypass Surgery. Abstract in 16thCardiovascular congress, Tehran, 2008: 187-90 (Persian)
Gallgher R, Mckinley S. Anxiety and Depression and Perceived Control in Patients Having Coronary Artery Bypass Graft. J Adv Nurs 2009; 65(11):2386-96
Fletcher G, Oken K, Safford R. Comprehensive Rehabilitation of Patients with Coronary Artery Disease. 7th Ed, Philadelphia. WB Saunders; 2001: 1407-17.
Woods.S. Cardiac Nursing. 6th ed .Sunders Elsevier, 2010
Delisa J. Physical Medical reahabilitation. 5th Ed. Philadelphia:W.B. 2010
Yu CM & et al. A Short Course of Cardiac Rehabilitation Program is Highly Cost Effective in Improving Long Term Quality of Life in Patients with Recent Myocardial Infarction or Percutaneous Coronary Invertention. Arch Phys Med Rehabil. 2004;85(12):1915-22
Kulcu DG& et al .The Effect of Cardiac Rehabilitation on Quality of Life, Anxiety and Depression in Patients with Congestive Heart Failure. J Adv Nurs 2007;43:489-97
Duaret Freitas P, Haid A, Bousquet M, Richard L, Mauriege P, Guiraud T. Short-term Impact of a Four-week Intensive Cardiac Rehabilitation Program on Quality of Life and Anxiety-Depression. Ann Phys Rehabil Med. 2011;54(3):132-43
Yohannes AM, Doherty P, Bundy C, Yalfani A.The Long Term Benefits of Cardiac Rehabilitation on Depression, Anxiety, Physical Activity and Quality of Life. J Clin Nurs. 2010;19(19-20):2806-13
Sharif F, Shoul A, Jannati N, Zare N, Kajouri J. The Effect Cardiac Rehabilitation Depression and Anxiety after Coronary Artery Bypass Surgery. Rehabilitation Journal. 2011;12(2):8-13 (Persian)
Shafiee m, The Effect Cardiac Rehabilitation on Hope after Coronary Artery Bypass Surgery Razavi Hospital , MS nursing thesis, school of nursing and midwifery, Mashhad University of Medical Sciences, Mashhad, 1389 (Persian)
Kaviani M, Saforian H, Sharifi V, Ebrahim khani N. Anxiety and Depression Inventory in an Iranian Population. Tehran University of Medical Sciences Journal. 2009; 67(5):379-85 (Persian)
Karke abadi M. Compression of Depression in Employed and Unemployed Mothers in Mashhad, MS thesis in mother and child health care, Mashhad University of Medical Sciences. 1998 (Persian)
Gorge M. The Effect of Cardiac Reahabilitation on Depression and Anxiety after Coronary Artery Bypass Surgery. 2012;11(3):12-6 (Persian)
Lavie CJ. Milani RV. Effects of Cardiac Rehabilitation, Exercise Training, and Weight Reduction on Exercise Capacity, Coronary Risk Factors, Beha-vioural Characteristics, and Quality of Life in Obese Coronary Patients. Am J Cardiol 1997; 79(4):397–401.
Michie S, O'Connor D, Bath J, Giles M, Earll L. Cardiac rehabilitation: The Psychological Changes that Predict Health Outcome and Healthy Behaviour. Psychology, Health & Medicine. 2005;10(1): 88-95
Hazavehei SM, Sabzmakan L, Hassanzadeh A, Rabiei K. The Effect of PRECEDE Model-based Educational Program on Depression Level in Patients with Coronary Artery Bypass Grafting. J Qazvin Univ Med Sci. 2008 ,12(2):32–40 (Persian)
Yoshida T, Kohzuki M, Yoshida K, Hiwatari M, Kamimoto M, Yamamoto C. Physical and Psychological Improvements after Phase II Cardiac Rehabilitation in Patients with Myocardial Infarction. Nurs Health Sci. 2002; 1(3): 163-70.
Myers J, Prakash M, Froelicher V, Do D, Partington S, Atwood JE. Exercise Capacity and Mortality among Men Referred for Exercise Testing. N Engl J Med. 2002;346(11):793–801