The Effect of a Psychosocial Intervention and Quality of Life After Acute Myocardial Infarction
| Autor: | James A. Blumenthal, Pamela Mitchell, Colin Wu, Carlos F. Mendes de Leon, Heejung Bang, Matthew M. Burg, Gail Ironson, Kenneth E. Freedland, Susan M. Czajkowski, Harlan M. Krumholz, Lynda H. Powell, Vicki DiLillo |
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| Rok vydání: | 2006 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Myocardial Infarction Psychological intervention law.invention Social support Randomized controlled trial Quality of life law medicine Humans Myocardial infarction Retrospective Studies Cognitive Behavioral Therapy Depression business.industry Rehabilitation Middle Aged medicine.disease humanities Clinical trial Cognitive behavioral therapy Treatment Outcome Quality of Life Physical therapy Female business Psychosocial Follow-Up Studies |
| Zdroj: | Journal of Cardiopulmonary Rehabilitation. 26:9-13 |
| ISSN: | 0883-9212 |
| DOI: | 10.1097/00008483-200601000-00002 |
| Popis: | Purpose The Enhancing Recovery in Coronary Heart Disease Patients (ENRICHD) clinical trial was designed to test whether intervening on depression or low perceived social support reduces mortality and reinfarction in patients with acute myocardial infarction (MI). This report analyzes the effect of the intervention on quality of life (QOL), which was an important secondary outcome. Methods ENRICHD was a randomized controlled clinical trial comparing a psychosocial intervention based on cognitive behavioral therapy to usual medical care in 2,481 patients from 8 clinical centers. Patients with acute MI were included if they met criteria for depression, low perceived social support, or both. QOL was assessed at the 6-month clinic visit in the first 1,296 patients. QOL measures included the Medical Outcomes Study Short Form summary measures of physical functioning (SF12-PCS) and mental functioning (SF12-MCS), a Life Satisfaction Scale (LSS), and a measure of overall QOL based on the ladder of life (LOL) technique. Results There were significant treatment differences on the SF12-MCS (difference 2.2, 95% confidence interval [CI] 1.2-3.2), the LSS (difference 1.0, 95% CI 0.5-1.5), and the LOL (difference 0.3, 95% CI 0.1-0.6), but not on the SF12-PCS (difference 0.8; 95% CI = -0.5-2.0). Effect sizes for the intervention on QOL outcomes were modest. Conclusions Psychosocial interventions of limited duration confer modest QOL benefits in post-MI patients who are depressed or have low perceived social support. Interventions of longer duration or greater intensity may be required to produce more substantial improvements in QOL in these patients. |
| Databáze: | OpenAIRE |
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