Who are the patients that take advantage from psychological intervention during cardiac rehabilitation?
Anna Maria Zotti, Silvia Rossi Ferrario, Gianluigi Balestroni, Paola Cerutti
The Italian Task Force for the Psychological Guidelines in Cardiac Rehabilitation (2003) recommended
screening coronary patients for anxiety and depression and to treat adequately those emerging with
these emotional disturbances.
Our retrospective study had the aim to evaluate the short term efficacy of a cognitive-behavioral brief
intervention on cardiac patients in a rehabilitation setting.
One hundred and fifty-two in-patients were interviewed by the psychologist the day of admission and
assessed for state anxiety and depression symptoms using STAI-X1 and QD questionnaires the day
after.
On the basis of the psychologist’s judgement and the questionnaires’ scores, patients were divided in
two groups: one receiving an health educational programme (HEP) and one other receiving the same
educational programme plus some sessions of cognitive-behavioral counselling (CBT). Before being
discharged from the hospital (about 12-15 days after the admission), all of the patients filled in the
same questionnaires again.
Results showed that patients with critical scores in anxiety, in the CBT group were correctly inserted
patients with critical scores in anxiety, depression or both, were correctly placed in the CBT group.
These patients were younger than those of HEP group and all of them still working. They reported
a significant decrease in emotional disturbances when compared to that of the HEP group. The
most important result, however, was the evidence that 44% of CBT patients were not identified by
the questionnaires’ scores but by the psychologist’s interview. This suggests caution in using the
questionnaires’ scores as discriminative of the patients’ needs, and underlines the importance of
involving the psychologist to realize a good clinical practice.
Keywords
Anxiety, depression, health education, cognitive-behavioral therapy, cardiac
rehabilitation.
