title: Which Factors Unexpectedly Increase Depressive Symptom Severity in Patients at the End of a Cardiac Rehabilitation Program?
abstract: OBJECTIVE
  To investigate predictors of depressive symptom aggravation at the end of a cardiac rehabilitation (CR) program.
  
  
  METHODS
  The design of the study was retrospective. The administrative data were obtained from the database of the CR department of a heart hospital in Iran. The demographic and clinical information of 615 CR patients between January 2000 and January 2010 was analyzed using binary logistic regression analysis.
  
  
  RESULTS
  The results showed that 10.7% of the patients completed the CR program with aggravated depressive symptoms. After adjustment for gender, age, and pre-intervention depression score, lower education level (p<0.05) and smoking (p<0.01) were significant predictors of increased depressive symptoms at the end of the program. Our model variables could explain 6% to 13% of the dependent variable variance.
  
  
  CONCLUSIONS
  The results suggest that targeting patients who are less literate or who smoke could allow for taking the required measures to prevent or control depression at the end of a CR program. It is suggested that future studies consider other variables.
authors.affiliation: Cardiac Rehabilitation Center, Imam ALI Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran.
authors.forename: Saeid
authors.initials: S
authors.lastname: Komasi
authors.affiliation: Cardiac Rehabilitation Center, Imam ALI Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran.
authors.forename: Mozhgan
authors.initials: M
authors.lastname: Saeidi
authors.affiliation: Imam ALI hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran.
authors.forename: Nafiseh
authors.initials: N
authors.lastname: Montazeri
authors.affiliation: Bistoon Hospital, Kermanshah, Iran.
authors.forename: Masoumali
authors.initials: M
authors.lastname: Masoumi
authors.affiliation: Department of Sports Medicine and Rehabilitation, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Soroush
authors.affiliation: Cardiac Rehabilitation Center, Imam ALI Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran.
authors.forename: Parvin
authors.initials: P
authors.lastname: Ezzati
keywords: Cardiac disease; Demographics; Depression; Patients; Rehabilitation