Indica News Bureau-
A new study reveals that group therapy relieves emotional distress, improves quality of life and reduces heart disease readmissions.
The study was published in the European Heart Journal, a journal of the European Society of Cardiology (ESC).
“About 20% of all heart patients show signs of distress, rising to a third of employed patients,” said a nurse at Copenhagen University Hospital in Denmark. Study author Annette Holdgaard said.
“Psychological symptoms, such as palpitations and chest discomfort, can be difficult to distinguish from cardiac symptoms. It can entail additional distress that can be limiting.”
Previous programs for dealing with psychological problems in heart patients were long and delivered to individuals by therapists or psychologists, making them difficult to use in real life.
This study examined the effects of five group sessions of cognitive-behavioral therapy (CBT), administered by nurses as an addition to routine cardiac rehabilitation, on symptoms of anxiety and depression.
This study included 147 working-age cardiac patients with emotional distress, defined as a Hospital Anxiety and Depression Scale (HADS) score of 8 or greater for anxiety and/or depression. I was.
The average age was 54 years and 67% were male. Participants were randomly assigned to her five sessions of group CBT plus usual cardiac rehabilitation (CBT group) or cardiac rehabilitation only (control group). Those with severe distress or a psychiatric diagnosis were excluded.
Cardiac rehabilitation was performed in 90-minute group sessions twice weekly for 8 weeks.
Sessions included exercise, medication adjustments, and education on diet, smoking, physical activity, weight, blood sugar, blood pressure, blood lipids, and psychological issues.
Cardiac nurses led CBT sessions after brief training and were supervised by a psychologist. Her 5 sessions of 2 hours each were given to groups of 3-4 patients.
In Session 1, patients clarified their values, such as family and work, and reported difficulties due to heart disease, such as sleep deprivation and fatigue.
Session 2 reviewed the Anxiety Ring, where threats can provoke physical reactions and catastrophic thoughts, followed by gradual exposure to anxiety-filled situations and the ability to calm the nervous system. A discussion was held on coping methods such as breathing techniques to make the patient feel sick.
Session 3 presented analysis and results of current behavior. For example, working 50 hours a week may satisfy you in the short term, but it doesn’t leave you enough time to recover from a heart condition that can have serious long-term consequences. Session 4 focused on strategies for addressing concerns.
Worrying can lead to problem solving, but it can also lead to overthinking, and patients learn to behave more constructively.
Finally, in session 5, patients review how their coping strategies have changed throughout the course, learn how to maximize their strengths, and develop individualized maintenance plans to deal with future distress. received.
The primary outcome of change in total HADS score from baseline to 3 months was significantly improved in the CBT group (8.0 points) than in the control group (4.1 points).
Both subscales (anxiety and depression) also improved significantly in the intervention group. Improvements in total scores and subscales in the CBT group were maintained for 6 months.
Compared to the control group, the CBT group had significantly improved quality of life at 6 months and a 57% lower risk of cardiac readmission at 12 months.
Previous studies have shown that patients with anxiety and depression are less likely to participate in cardiac rehabilitation exercises and educational sessions, and in this study, patients who underwent CBT participated more than patients in the control group. shown to be likely.
Holdgaard said: People in therapy groups said they found it comforting to be with others coping with the same issues. For example, there may be other reasons why your heart is beating faster than it is dying. Nurses helped distinguish between cardiac symptoms and psychological symptoms. I realized that I could keep my distance (dissociation) and let thoughts pass. ”
ESC spokesperson Professor Christi Deaton of the University of Cambridge, UK, said: This demonstrates the value of an intervention for psychological distress and demonstrates that a simple group-based CBT of her can be performed by a nurse within an existing cardiac rehabilitation program and has a positive and significant effect on outcomes. bring. ”
“This study also demonstrates the importance of individualizing rehabilitation programs to meet the needs of different patient groups. It has been shown to be a promising intervention for patients in distress.
