title: Intensive rehabilitation of emotionally distressed patients after coronary by-pass grafting.
abstract: OBJECTIVE
  To evaluate whether the status of emotionally distressed post coronary by-pass surgery patients can be improved by a comprehensive, in-patient rehabilitation programme.
  
  
  METHODS
  Cross-sectional.
  
  
  METHODS
  Rehabilitation hospital.
  
  
  METHODS
  One hundred and fifty-two post coronary by-pass surgery patients referred to an intensive rehabilitation programme. The study group was divided into two subgroups, according to the level of emotional distress. Forty-three (30%) out of 142 patients who completed the Nottingham Health Profile were considered to be distressed.
  
  
  METHODS
  The comprehensive 4-week inpatient rehabilitation programme consisted of daily physical exercise, lectures about coronary disease and risk factors, psychological support and nutrition counselling.
  
  
  METHODS
  Physical fitness, blood lipids and quality of life questionnaires.
  
  
  RESULTS
  The two-way analysis of variance showed that emotionally distressed patients achieved equally good results as those obtained by nondistressed patients in performance regarding the maximal exercise stress test, maximum rate pressure product achieved, or the level of resting heart rate. Significant improvement in psychological well-being as assessed by a seven-point rating scale was observed in both groups. Both groups of patients were also equally successful in weight reduction and lowering of total cholesterol and triglycerides. Of all the patients who were employed at admission, twice the number of patients in the distressed group were in receipt of a permanent disability pension and half the number of patients was employed, compared to the initially nondistressed group, at 1-year follow-up.
  
  
  CONCLUSIONS
  Distressed patients were very successful in improving their functional status and reducing risk factors when offered an intensive rehabilitation programme but they were much less successful in returning to work. Secondly, patients who were emotionally distressed after surgery did not differ in regard to disease status or physical capacity from nondistressed patients. They did, however, experience more angina pectoris both in daily life and when exposed to a maximal exercise stress test. Finally, the presence of emotional distress was easily detected by any measure of psychological status.
authors.affiliation: Division of Preventive Medicine, Söder Hospital, Karolinska Institute, Stockholm, Sweden. aleksander.perski@ipm.ki.se
authors.forename: A
authors.initials: A
authors.lastname: Perski
authors.forename: K
authors.initials: K
authors.lastname: Osuchowski
authors.forename: L
authors.initials: L
authors.lastname: Andersson
authors.forename: A
authors.initials: A
authors.lastname: Sanden
authors.forename: E
authors.initials: E
authors.lastname: Feleke
authors.forename: G
authors.initials: G
authors.lastname: Anderson
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001007:Anxiety / Q000209:etiology; D001026:Coronary Artery Bypass / Q000523:psychology* / Q000534:rehabilitation*; D003430:Cross-Sectional Studies; D003863:Depression / Q000209:etiology; D015444:Exercise; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D009747:Nutritional Physiological Phenomena; D010353:Patient Education as Topic; D010809:Physical Fitness; D011788:Quality of Life; D012046:Rehabilitation / Q000379:methods; D013315:Stress, Psychological / Q000209:etiology / Q000523:psychology / Q000628:therapy*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D008055:Lipids