Ana Cláudia Fernandes (a), Teresa McIntyre (b), Rui Coelho (c,d), Joana Prata (c,d,∗), Maria Júlia Maciel (e)

(a) Faculdade de Filosofia e Ciências Sociais, Universidade Católica Portuguesa, Braga, Portugal
(b) School of Education and Behavioral Sciences, Houston Baptist University, USA
(c) Instituto de Investigac¸ão e Inovac¸ão em Saúde (i3S), Universidade do Porto, Porto, Portugal
(d) Departamento de Neurociências Clínicas e Saúde Mental, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
(e) Faculdade de Medicina, Universidade do Porto, Portugal

Received 16 November 2016; accepted 28 January 2017
Available online 4 September 2017

Abstract

Introduction: Acute coronary syndrome (ACS) is an important cause of mortality and significant personal and financial costs. Cardiac rehabilitation (CR) programs have shown positive effects in reducing cardiovascular mortality and improving functional capacity. However, adherence
is low and appears to be influenced by psychosocial factors, such as patients’ cognitions and emotional state. The objective was to evaluate the efficacy of a brief in-hospital psychological intervention to promote cognitive and emotional adaptation after ACS.

Methods: One hundred and twenty-one patients with ACS, admitted to a coronary care unit in a central hospital, were randomized to an experimental group (EG, n=65) and a control group (CG, n=56). Portuguese versions of the HADS and BIPQ were used to measure emotional well-being and illness cognitions. Two 1 h 15 min sessions were conducted 2-3 days after hospital admission, and a 20-minute follow-up session took place one month after discharge. Patients were assessed at four different time points: pre-test, post-test, and at 1- and 2-month follow-up.

Results: The intervention had significant effects on anxiety, depression and illness cognitions.
Anxiety and depression were significantly reduced and illness cognitions improved significantly in the EG compared to the control group. For the EG, these changes were maintained or enhanced at 1- and 2-month follow-up, whereas for the CG there was a deterioration in psychosocial adjustment.