Enhancing emotional well-being by comprehensive rehabilitation in patients with coronary heart disease

Since emotional distress is linked to poor prognosis in coronarypatients, there is urgent need for research into interventionsthat may enhance emotional well-being in these patients. Cardiacrehabilitation aims to return the individual to optimal emotionalfunction, but the psychological effect of this therapy stillneeds to be demonstrated Hence, we examined the role of cardiacrehabilitation in enhancing emotional health. We examined 170male patients with coronary heart disease, of whom 85 had participatedin the outpatient rehabilitation programme of the UniversityHospital of Antwerp and 85 had received standard medical careonly in two other hospitals. Rehabilitation and control patientswere matched by medical category and tendency to experiencedistress. The Global Mood Scale, the Health Complaints Scale,and the Heart Patients Psychological Questionnaire were usedto assess changes in emotional well-being over a 3-month period.These changes were significantly different as a function ofcardiac rehabilitation (P<0•0001). Rehabilitation patients,but not control patients, reported a significant improvementin negative affect, positive affect, well-being, health anddisability (P<0•0001). At follow-up, differences indepression, tranquillizer use (P<0•005). and activityprofile (P<0•01) confirmed that rehabilitation patientsdisplayed more healthy behaviour than control patients. Patientsnot only improved more, but also deteriorated less as afunctionof rehabilitation. This therapy also had a positive effect onpatients suffering minimal distress, which is at variance withprevious research. These findings suggest that comprehensiverehabilitation may be an effective therapy for enhancing emotionalwell-being in patients with coronary heart disease.