Psychological well-being in obese inpatients with ischemic heart disease at entry and at discharge from a four-week cardiac rehabilitation program

Manzoni Manzoni

doi:10.3389/fpsyg.2010.00038

Abstract

The purposes of this observational pre-post study were twofold: 1- to evaluate psychological health in obese patients with ischemic heart disease at admission to cardiac rehabilitation (CR) and 2 – to examine the effectiveness of a 4-week CR residential program in improving obese patients’ psychological well-being at discharge from CR. A sample of 177 obese patients completed the Psychological General Well-Being Inventory (PGWBI) at admission to the CR program and at discharge. The equivalence testing method with normative comparisons was used to determine the clinical significance of improvements after having established that baseline mean scores on the PGWBI scales were significantly lower than normal means. Results show that patients scored equally or better than norms on many PGWBI dimensions at admission to CR but scored significantly worse on Global Score, Vitality and Self-control. At discharge, mean scores that were impaired at baseline returned to normal levels at the more conservative equivalence interval. A 4-week CR program was thus effective in improving obese patients’ psychological well-being. The equivalence testing method allowed to establish the clinical significance of such improvement.

Highlights

Obesity increases several coronary risk factors such as hypertension, hyperlipidemia, insulin resistance, hypercoagulation, generalized inflammatory state and sedentary life style (Savage and Ades, 2006; Lavie et al, 2009; Vanhecke et al, 2009). This is why rates of heart disease are far greater among overweight and obese individuals than in the general population, and nearly 80% of cardiac rehabilitation (CR) patients are overweight or obese (Brochu et al, 2000; Bader et al, 2001; Sierra-Johnson et al, 2005)
It has been observed that obese individuals with higher body mass index (BMI), the ones seeking surgical weight-loss treatment and the ones with a high number of acquired co-morbid illnesses have the lower scores in quality of life (QoL) measures (Doll et al, 2000; Kushner and Foster, 2000; Kolotkin et al, 2001)
Study sample We studied data from 175 white inpatients (52 females – 29.7%) with obesity and ischemic heart disease (IHD) who were referred to residential CR

Summary

Introduction

Obesity increases several coronary risk factors such as hypertension, hyperlipidemia, insulin resistance, hypercoagulation, generalized inflammatory state and sedentary life style (Savage and Ades, 2006; Lavie et al, 2009; Vanhecke et al, 2009). This is why rates of heart disease are far greater among overweight and obese individuals than in the general population, and nearly 80% of cardiac rehabilitation (CR) patients are overweight or obese (Brochu et al, 2000; Bader et al, 2001; Sierra-Johnson et al, 2005). It has been observed that obese individuals with higher BMIs, the ones seeking surgical weight-loss treatment and the ones with a high number of acquired co-morbid illnesses have the lower scores in QoL measures (Doll et al, 2000; Kushner and Foster, 2000; Kolotkin et al, 2001)

Methods

Results

Conclusion