Abstract
This intervention assessed the effects of a brief intervention on dropout rate in a cardiac rehabilitation program. One hundred thirty five patients were recruited from a cardiac rehabilitation program and randomized to either a control or intervention group. The intervention group participated in four sessions of motivational interviewing and stress management-relaxation in addition to standard cardiac rehabilitation. The control group underwent cardiac rehabilitation alone. Patients who completed the intervention completed an average of 30 sessions while those who dropped out of the intervention completed about six (p < 0.001). Anxiety and depression measured at baseline were the primary predictors of dropout. Patients in both the intervention and controls groups who completed cardiac rehabilitation improved the distance walked, quality of life and decreased anxiety.
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Albert, C. M., Chae, C. U., & Rexrode, K. M. (2005). Phobic anxiety and risk of coronary heart disease and sudden cardiac death among women. Circulation, 11, 480–487.
Arrigo, I., Brunner-Larocca, H., Lefkovits, M., Pfisterer, M., & Hoffmann, A. (2008). Comparative outcome 1 year after formal cardiac rehabilitation: The effects of a randomized intervention to improve exercise adherence. European Journal of Cardiovascular Prevention and Rehabilitation, 15, 306–310.
Badenhop, D. T., Chapman, B., Franker, T., & Smith, I. (1999). Performance and improvement on 12 minute walk distance during phase II cardiac rehabilitation. Journal of Cardiopulmonary Rehabilitation and Prevention, 19, 309.
Badenhop, D., Collins, C., Boardley, D., & Rock-Willoughby, J. (2013). Validity of a 12 minute walk test to assess peak VO2 in phase II cardiac rehabilitation patients. Medicine & Science in Sports & Exercise, 45(Supplement 5), S479–S480.
Baker, D. W., DeWalt, D. A., Schillinger, D., Hawk, V., Ruo, B., Bibbins-Domingo, K., et al. (2011). “Teach to goal”: Theory and design principles of an intervention to improve heart failure self-management skills of patients with low health literacy. Journal of Health Communication, 16(3), 73–88.
Beck, A. T., Epstein, N., Brown, G., & Steer, R. A. (1998). An inventory for measuring clinical anxiety: Psychometric properties. Journal of Consulting and Clinical Psychology, 56, 893–897.
Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Beck depression inventory (2nd ed.). San Antonio, TX: The Psychological Corporation.
Bittner, V., Weiner, D. H., Yusuf, S., Rogers, W. J., McIntyre, K. M., & Bangdiwala, S. I. (1993). Prediction of mortality and morbidity with a 6-minute walk test in patients with left ventricular dysfunction. The Journal of the American Medical Association, 270, 1702–1707.
Carroll, K. M., Ball, S. A., Nich, C., Martino, S., Frankforter, T. L., Farentinos, C., et al. (2006). Motivational interviewing to improve treatment engagement and outcome in individuals seeking treatment for substance abuse: A multisite effectiveness study. Drug and Alcohol Dependence, 81(3), 301–312.
Davis, M., Eshelman, E., & McKay, M. (2008). The relaxation and stress reduction workbook (6th ed.). Oakland, CA: New Harbinger Publications.
Dehdari, T., Heidarnia, A., Ramezankhani, A., Sadeghian, S., & Ghofranipour, F. (2009). Effects of progressive muscular relaxation training on quality of life in anxious patients after coronary artery bypass graft surgery. Indian Journal of Medical Research, 129(5), 603–608.
Engebretson, T. O., Clark, M. M., Niaura, R. S., Phillips, T., Albrecht, A., & Tilkemeier, P. (1999). Quality of life and anxiety in a phase II cardiac rehabilitation program. Medicine and Science in Sports and Exercise, 31(2), 216–223.
Grace, S. L., Abbey, S. E., Pinto, R., Shnek, Z. M., Irvine, J., & Stewart, D. E. (2005). Longitudinal course of depressive symptomatology after a cardiac event: Effects of gender and cardiac rehabilitation. Psychosomatic Medicine, 67(1), 52–58.
Halm, M. A. (2009). Relaxation: A self-care healing modality reduces harmful effects of anxiety. American Journal of Critical Care, 18, 169–172.
Joliffe, J. A., Rees, K., Taylor, R. S., Thompson, D., Oldridge, N., & Ebrahim, S. (2001). Exercise-based rehabilitation for coronary heart disease. Cochrane Database of Systematic Reviews, 1. doi:10.1002/14651858.CD001800.
Jones, K. D., Bruckhardt, C. S., & Bennet, J. A. (2004). Motivational interviewing may encourage exercise in persons with fibromyalgia by enhancing self-efficacy. American College of Rheumatology, 51(5), 864–867.
Lear, S. A., Ignaszewski, A., Linden, W., Brozic, A., Kiess, M., Spinelli, J. J., et al. (2003). The extensive lifestyle management intervention (ELMI) following cardiac rehabilitation trial. European Heart Journal, 24, 1920–1927.
McEntee, D. J., & Badenhop, D. T. (2000). Quality of life comparisons: Gender and population differences in cardiopulmonary rehabilitation. Heart and Lung, 29, 340–347.
McGrady, A. (2010). The effects of biofeedback in diabetes and essential hypertension. Cleveland Clinic Journal of Medicine, 77(3), S68–S71.
McGrady, A., McGinnis, R., Badenhop, D., Bentle, M., & Rajput, M. (2009). Effects of depression and anxiety on adherence to cardiac rehabilitation. Journal of Cardiopulmonary Rehabilitation and Prevention, 29(6), 358–369.
Milani, R. V., & Lavie, C. J. (2007). Impact of cardiac rehabilitation on depression and its associated mortality. American Journal of Medicine, 120(9), 799–806.
Miller, W. R., & Rollnick, S. (2002). Motivational interviewing: Preparing people for change (2nd ed.). London: The Guilford Press.
Ozer, Z. C., Sunuzun, F., & Tokem, Y. (2009). Evaluation of anxiety and depression levels in patients with myocardial infarction. Archives of the Turkish Society of Cardiology, 37, 557–562.
Paradis, V., Cossette, S., Frasure-Smith, N., Heppell, S., & Guertin, M. C. (2010). The efficacy of a motivational nursing intervention based on the stages of change on self-care in heart failure patients. Journal of Cardiovascular Nursing, 25(2), 130–141.
Pignotti, M., & Steinberg, M. (2001). Heart rate variability as an outcome measure for though field therapy in clinical practice. Journal of Clinical Psychology, 57, 1193–1206.
Plüss, C. E., Billing, E., Held, C., Henriksson, P., Kiessling, A., Karlsson, M. R., et al. (2011). Long-term effects of an expanded cardiac rehabilitation program after myocardial infarction or coronary artery bypass surgery: A five-year follow-up of a randomized controlled study. Clinical Rehabilitation, 25, 79–87.
Poulsen, S. H., Jensen, S. E., Moller, J. E., & Eqstrup, K. (2001). Prognosis value of left ventricular diastolic function and association with heart rate variability after first acute myocardial infarction. Heart, 86(4), 376–380.
Reigel, B., Moser, D. K., & Anker, S. D. (2009). State of science: Promoting self-care in persons with heart failure a scientific statement from the American Heart Association. Circulation, 120, 1141–1163.
Rollnick, S., Miller, W. R., & Butler, C. C. (2008). Motivational interviewing in healthcare. London: The Guilford Press.
Shepherd, C. W., & White, A. E. (2012). Cardiac rehabilitation and quality of life: A systematic review. International Journal of Nursing Studies, 49(6), 755–771.
Smeulders, E., van Haastregt, J., van Hoef, E., van Eijk, J. T., & Kempen, G. I. (2006). Evaluation of a self-management programme for congestive heart failure patients: Design of a randomized controlled trial. BMC Health Services Research, 6, 91.
von Känel, R. (2012). Psychosocial stress and cardiovascular risk: Current opinion. Swiss Medical Weekly, 142, 0.
Vos, C. D., Li, X., Vlaenderen, I. V., Saka, O., Dendale, P., Eyssen, M., et al. (2013). Participating or not in a cardiac rehabilitation programme: Factors influencing a patient’s decision. European Journal of Preventive Cardiology, 20(2), 341–348.
Ware, J.E., & Kosinski, M. (1996). The SF-36 health survey (Version 2.0) Technical Note. Boston, MA: Health Assessment Lab.
Ware, J. E., Kosinski, M., & Dewey, J. E. (2000). How to score version 2 of the SF-36 health survey. Lincoln, RI: Quality Metric Incorporated.
Worcester, M. U. C., Murphy, B. M., Mee, V. K., Roberts, S. B., & Goble, A. J. (2004). Cardiac rehabilitation programmes: Predictors of non-attendance and drop-out. European Society of Cardiology, 11(4), 328–335.
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We thank the staff of the Cardiac Rehabilitation Program at The University of Toledo Health Science Campus.
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These results were presented at the 2014 annual meeting of the Association for Applied Psychophysiology and Biofeedback, March, Savannah, Georgia.
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McGrady, A., Burkes, R., Badenhop, D. et al. Effects of a Brief Intervention on Retention of Patients in a Cardiac Rehabilitation Program. Appl Psychophysiol Biofeedback 39, 163–170 (2014). https://doi.org/10.1007/s10484-014-9252-y
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DOI: https://doi.org/10.1007/s10484-014-9252-y