Effects of self-help post-myocardial-infarction rehabilitation on psychological adjustment and use of health services.
A home-based exercise programme has been found to be as useful as a hospital-based one in improving cardiovascular fitness after an acute myocardial infarction. To find out whether a comprehensive home-based programme would reduce psychological distress, 176 patients with an acute myocardial infarction were randomly allocated to a self-help rehabilitation programme based on a heart manual or to receive standard care plus a placebo package of information and informal counselling. Psychological adjustment, as assessed by the Hospital Anxiety and Depression Scale, was better in the rehabilitation group at 1 year. They also had significantly less contact with their general practitioners during the following year and significantly fewer were readmitted to hospital in the first 6 months. The improvement was greatest among patients who were clinically anxious or depressed at discharge from hospital. The cost-effectiveness of the home-based programme has yet to be compared with that of a hospital-based programme, but the findings of this study indicate that it might be worth offering such a package to all patients with acute myocardial infarction.
Lewin
B
B
Department of Clinical Psychology, Astley Ainslie Hospital, Edinburgh.
Robertson
I H
IH
Cay
E L
EL
Irving
J B
JB
Campbell
M
M
D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001007:Anxiety; D003863:Depression; D015444:Exercise; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000523:psychology / Q000534:rehabilitation*; D012648:Self Care / Q000523:psychology*; D006113:United Kingdom