ABSTRACT

Background

Cardiac rehabilitation (CR) has been successful in improving exercise capacity (EC) and quality of life (QoL). However, depression and anxiety are highly prevalent among cardiac patients and might represent risk factors for rehabilitation outcomes. The aim of this study was to investigate the role of depression and anxiety as possible independent risk factors for CR outcomes.

Methods

The study applied a pre-post-design. The sample comprised N = 3’434 cardiac disease patients taking part in a Swiss inpatient CR center. Variables measured at the beginning (T1) and end of rehabilitation (T2) included depression and anxiety (HADS), EC, and QoL (MacNew). A path analysis was conducted.

Results

Depression at T1 had a significant negative relationship with improvements in EC and in all aspects of QoL during rehabilitation. Anxiety at T1 was positively related to improvements in EC and in emotional and physical QoL. Improvements in depression during CR were positively related with improvements in all outcomes. Improvements in anxiety showed no significant association with the outcomes.

Conclusion

Depression and anxiety should be screened for during CR. Depression should be treated due to the negative association found with rehabilitation outcomes. Underlying mechanisms of the positive association of anxiety with rehabilitation outcomes need further investigation.

中文翻译：

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心脏康复中的抑郁和焦虑：与运动能力和生活质量变化的不同关联

摘要

背景

心脏康复 (CR) 在提高运动能力 (EC) 和生活质量 (QoL) 方面取得了成功。然而，抑郁和焦虑在心脏病患者中非常普遍，可能是康复结果的危险因素。本研究的目的是调查抑郁和焦虑作为 CR 结局可能独立危险因素的作用。

方法

该研究采用了前后设计。样本包括 参加瑞士住院 CR 中心的N = 3,434 名心脏病患者。在康复开始 (T1) 和康复结束 (T2) 测量的变量包括抑郁和焦虑 (HADS)、EC 和 QoL (MacNew)。进行了路径分析。

结果

T1 时的抑郁与 EC 的改善和康复期间生活质量的各个方面都有显着的负相关。T1 时的焦虑与 EC 以及情绪和身体 QoL 的改善呈正相关。CR 期间抑郁症的改善与所有结果的改善呈正相关。焦虑的改善与结果没有显着相关性。

结论

在 CR 期间应筛查抑郁和焦虑。由于发现与康复结果呈负相关，应治疗抑郁症。焦虑与康复结果呈正相关的潜在机制需要进一步研究。