Abstract
Anxiety and depression are thought to influence the genesis of ischemic diseases and not of valvular diseases, but little is known on the psychological profile of cardiac patients after surgery. Aim of this study was to investigate differences in disease experience and mood between patients undergoing cardiac rehabilitation after coronary artery by-pass graft (CABG) or after valve replacement (VR). We studied 1,179 CABG and 737 VR patients who completed the Illness Behaviour Questionnaire and the Hospital Anxiety and Depression Scale after surgery. We tested the independent effect of the type of surgery by multivariate analysis and between-group differences in prevalence of clinically relevant scores. Relevant scores in the psychosomatic concern scale were more frequent in CABG than in VR patients. After correction by age, sex, education and marital status, scores of disease conviction and psychosomatic concern were higher in CABG patients, scores of denial were higher in VR patients. Unexpectedly, anxiety and depression scores did not differ between groups. Results suggest providing psychological support for anxiety and depression to both VR and CABG patients during cardiac rehabilitation, and planning differentiated interventions of cardiac rehabilitation and secondary prevention tailored to the specific psychological reactions of CABG and VR patients.
Highlights
The psychological profile after cardiac surgery may depend on the preoperative clinical condition, on duration and severity of the disease and its symptoms, and on the type of cardiac surgery
Two hundred and eighty-eight of the 2,204 enrolled patients were excluded from the analysis because they had both coronary and valvular disease, and it was not possible to identify an unique indication for surgery
The final sample consisted of 1,916 patients who had a mean age of 65.2 ±12.4 years and were prevalently males (71%); 28% were single, and just under half of them had had a high-school or university degree (46%)
Summary
The psychological profile after cardiac surgery may depend on the preoperative clinical condition, on duration and severity of the disease and its symptoms, and on the type of cardiac surgery In this context, numerous studies underlined the impact of anxiety and depression on the genesis of the ischemic heart disease. Main aim of the present study is to test the hypothesis that cardiac patients after coronary surgery have greater levels of anxiety and depression than patients who underwent valvular surgery Second aim of our study is to provide a detailed description of the differences in disease experience and mood associated with these two types of cardiac disease This was done by evaluating a large population of cardiac patients (N = 2204) undergoing post-surgical rehabilitation after coronary or valvular diseases with standard validated questionnaires
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