Cognitive behavioral therapy in depressed cardiac surgery patients: role of ejection fraction.
OBJECTIVE
The aim of this study was to evaluate the relationship of ejection fraction (EF) and depressive symptoms in cardiac surgery patients assigned to nurse-guided cognitive behavioral therapy (CBT) or usual care (UC).


METHODS
Depressive symptoms were assessed using the Beck Depression Inventory (BDI). Seventy-seven patients (31% women; mean [SD] age, 63.6 [9.8] years) received 8 weeks of either CBT or UC. Using repeated-measures analysis of variance, changes in depressive symptoms over time were evaluated.


RESULTS
There was a significant interaction among time, treatment group, and EF status (p = 0.019). In the patients with preserved EF (≥40%), mean BDI scores in the UC group worsened by 1.9%, whereas those in the CBT group improved by 31.0%. In the patients with low EF (<40%), mean BDI scores worsened by 26.8% and improved by 75.3% in the UC and CBT groups, respectively.


CONCLUSIONS
Nurse-guided CBT is effective in reducing depressive symptoms after cardiac surgery, particularly in patients with low EF.
Boyoung Hwang, PhD Assistant Professor, School of Nursing, University of California, Los Angeles. Jo-Ann Eastwood, PhD Assistant Professor, School of Nursing, University of California, Los Angeles. Anthony McGuire, PhD Assistant Professor, School of Nursing, California State University, Long Beach. Belinda Chen, MPH Project Director, School of Nursing, University of California, Los Angeles. Rebecca Cross-Bodán, PhD Assistant Professor, School of Nursing, California State University, Fullerton. Lynn V. Doering, DNSc Professor and Chair, Translational Sciences, School of Nursing, University of California, Los Angeles.
Boyoung
B
Hwang
Jo-Ann
JA
Eastwood
Anthony
A
McGuire
Belinda
B
Chen
Rebecca
R
Cross-Bodán
Lynn V
LV
Doering
D006348:Cardiac Surgical Procedures; D015928:Cognitive Behavioral Therapy; D003863:Depression / Q000503:physiopathology* / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000503:physiopathology* / Q000628:therapy*; D013318:Stroke Volume