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

(a) Trofa Saúde Hospital, Braga Centro / Braga Sul, Portugal
(b) School of Social Work, University of Texas, Arlington, USA
(c) Departamento de Neurociências Clínicas e Saúde Mental, Faculdade de Medicina, Universidade do Porto, Portugal
(d) Clínica de Psiquiatria e Saúde Mental, Centro Hospitalar Universitário São João, Porto, Portugal
(e) Instituto de Investigac¸ão e Inovac¸ão em Saúde (i3S), Portugal
(f) Faculdade de Medicina, Universidade do Porto, Portugal

Received 6 June 2017; accepted 10 September 2018
Available online 17 June 2019

Abstract

Introduction: This study examined the efficacy of a brief inpatient psychoeducational intervention on knowledge about acute coronary syndromes (ACS), control of risk factors, and adaptive health habits and lifestyle. The intervention was intended to facilitate rehabilitation after ACS and its short- and medium-term impact was assessed.

Methods: One hundred and twenty-one patients with ACS, admitted to a central cardiology unit in Portugal, were randomized to an experimental group (EG, n=65) or a control group (CG, n=56). We used the Portuguese versions of the Knowledge Questionnaire and the Health Habits Questionnaire. Patients were assessed at hospital admission, hospital discharge and one- and two-month follow-up.

Results: The intervention had a significant impact, increasing knowledge about ACS (F=500.834; p=0.000) in the EG, which was maintained at two-month follow-up, and changing health habits at two-month follow-up (F=218.129; p=0.000). The CG demonstrated decreased knowledge (F=3.368; p=0.069) during the same period.

Conclusions: A brief inpatient psychoeducational intervention has a positive effect on knowledge about ACS, risk factor control and promotion of positive health habits, and is effective in improving cardiac rehabilitation.

© 2019 Sociedade Portuguesa de Cardiologia. Published by Elsevier España, S.L.U. All rights reserved.

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.

Ana Cláudia Vieira Lopes
Fernandes(1)
Maria Teresa Mendonça
McIntyre(2)

1) Psicológa, Mestre em Psicologia da Saúde pela Universidade do Minho. Doutoranda em Psicologia na Universidade do Minho.
Professora Assistente da Licenciatura em Psicologia no Instituto Superior da Maia.
2) Psicológa, Professora Associada com Agregação, Coordenadora Mestrado e Doutoramento em Psicologia da Saúde da Universidade do Minho.

Recebido em: 17/01/2006
Revisado em: 04/03/2006
Aceito em: 05/04/2006

Abstract

This work makes a brief review of the literature on the relation between psychosocial factors and post-acute myocardial infarction (AMI) rehabilitation, aiming at basing the development of psychosocial intervention programs for these patients. A psychological intervention program meant for improving the AMI-patients’ adjustment to illness and quality of life is described. A preliminary study on the program efficacy is presented, comparing the psychosocial intervention modality (study group – SG) in relation to a control group (CG) of traditional medical intervention modality. The investigation had a quasi-experimental outlining, with the sample consisting of 41 male patients from the cardiological services of 3 hospitals from Portugal north region, with ages comprehended between 35 to 70 years old. The intervention variables were depression, anxiety, the representations of the illness and health habits and life style. The patients were evaluated after the AMI occurrence (internment) and 3 months after the discharge from hospital.
The main hypothesis supposed the existence of significant differences between the SG and the CG, both in pre and post test, in the sense of better psychosocial results post-AMI for the SG. The obtained results pointed out for a positive effect of the intervention in the SG when compared to the CG in terms of depression, anxiety, comprehension of the illness and perception of its duration, treatment control, nutrition and physical activity.
These results show the importance of this type of intervention in the improvement of wellbeing and adjustment to the illness.

Teresa McIntyre, Ana Cláudia Fernandes, & Vera Araújo-Soares
Instituto de Educação e Psicologia, Universidade do Minho

Abstract

This paper describes a study which aims at investigating some indicators of the differential efficacy of a multimodal biopsychosocial intervention and biomedical intervention in the rehabilitation of the post acute myocardial infarction. The sample is composed of 32 patients of both sexes, aged 35-65, being seen at cardiology unit of a central hospital. A significant difference was predicted between the pre and post intervention moments in the medical and psychosocial variables studied for the biopsycosocial group but not for the biomedical group, in the direction of a decrease in the indicators of anxiety, depression and hostility and a increase in healthy behaviours. The result point to positive changes in the byopsichosocial group in various aspects related to the post acute myocardial infarction rehabilitation. The discussion and critical analysis of the results is carried out according to the theoretical frame of reference.