Efficacy of Alternative Cardiac Rehabilitation Delivery Formats in Improving Psychological Symptoms after Coronary Artery Bypass Grafting

Abstract

Background: Health-care systems always strive for alternative cardiac rehabilitation (CR) models to ensure that options available to patients better fit their needs, risk factor profiles, and preferences. We assessed the effects of hospital-based cardiac rehabilitation (HBCR) and hybrid cardiac rehabilitation (HCR) on psychological symptoms (i.e., anxiety, depression, and stress) among patients following coronary artery bypass graft surgery (CABG). Methods: This cross-sectional study recruited 115 CABG patients who were referred to the Department of Cardiac Rehabilitation at Imam Ali Hospital in the Iranian city of Kermanshah between January and May 2016. The patients were assigned to 1 of the 2 programs of HBCR (26 sessions) and HCR (10 sessions). The study population's psychological symptoms were assessed using the Depression, Anxiety, and Stress Scale (DASS) before and after the intervention, and the data were analyzed using paired t-tests and ANCOVA. Results: A total of 105 (91%) patients concluded the CR program. Respectively, 50.8% and 26.2% of the participants in the HBCR and HCR programs were female. The mean age was 59.6±9.2 years in the HBCR group and 58.7±6.1 years in the HCR group. The ANCOVA results indicated that both HBCR and HCR programs were equally effective in reducing anxiety (P=0.001 vs. P=0.015) and stress (P=0.002 vs. P=0.003) among the CABG patients, while only HBCR was effective in alleviating depressive symptoms (P=0.001). Conclusion: Our results demonstrated the efficacy of HBCR and HCR in diminishing stress and anxiety levels among the CABG patients. However, depression was affected only by HBCR.