Effects of a cardiac rehabilitation course on psychological stresses in an Iranian population

BACKGROUND: The complications of cardiovascular diseases (CVDs) include psychological stresses such as anxiety, depression, and hostility. They cause disease exacerbation and prolongation and delayed improvement. Some studies have reported rehabilitation and stress management interventions to be helpful in reducing such stresses. Due to the high prevalence of CVDs in Isfahan, Iran, the present study evaluated the effects of a cardiac rehabilitation course on psychological stresses in an Iranian population. METHODS: A total number of ۱۹۰ patients (۴۰ females and ۱۵۰ males), who have been introduced by cardiologists to Isfahan Cardiovascular Research Center for rehabilitation following the myocardial infarction and open heart surgery, participated in this study. Patients all took part in an exercise program including ۲۴ one-hour sessions (three sessions per week). Each session consisted of warm-up (۲۰ minutes), aerobic exercise and relaxation (۴۰ minutes). Cognitive-therapeutic group therapy sessions, supervised by a psychiatrist, were also held for ۱-۲ hours weekly. Furthermore, patients' nutritional pattern was controlled by a nutritionist. All the individuals underwent exercise test at the beginning and the end of the exercise. In addition, anxiety, depression, and hostility were assessed by symptom checklist-۹۰ (SCL-۹۰) before and after the course. The data was analyzed by paired-t and independent-t tests in SPSS. RESULTS: The exercise volume in all the patients (۴۲.۷ ± ۸۱.۵۶ in males and ۳۹.۸۸ ± ۳۳.۳۶ in females) significantly increased at the end of the course. Moreover, scores of anxiety (-۱۷.۸۶ ± ۶۸.۴۹ in males and -۳۲.۳۳ ± ۴۹.۵۳ in females), depression (-۱۲.۸۰ ± ۶۷.۴ in males and -۱۶.۵۰ ± ۵۷.۸۴ in females), and hostility (-۱۹.۲۶ ± ۷۱.۸۶ in males and -۱۲.۸۰ ± ۱۲۳.۶۰ in females) showed a significant reduction at the end of the course (P < ۰.۰۰۱). Similar results were seen in both sexes. CONCLUSION: According to the changes found after rehabilitation, it can be concluded that the conducted rehabilitation program was helpful in reducing stresses among the studied population. Such programs can thus be an effective approach to reduce stress and its outcomes. In addition, there were no significant differences in the effectiveness of the program on psychological factors between males and females. Keywords: Cardiac Rehabilitation, Exercise Volume, Depression, Anxiety, Hostility