“Prehabilitation” prior to CABG surgery improves physical functioning and depression

Furze, Gill, Dumville, Jo C., Miles. Jeremy N. V., Irvine, Karen, Thompson, David R. and Lewin, Robert J. P. (2009) “Prehabilitation” prior to CABG surgery improves physical functioning and depression. International Journal of Cardiology, 132 1: 51-58. doi:10.1016/j.ijcard.2008.06.001


Author Furze, Gill
Dumville, Jo C.
Miles. Jeremy N. V.
Irvine, Karen
Thompson, David R.
Lewin, Robert J. P.
Title “Prehabilitation” prior to CABG surgery improves physical functioning and depression
Journal name International Journal of Cardiology   Check publisher's open access policy
ISSN 0167-5273
1874-1754
Publication date 2009-02-06
Year available 2008
Sub-type Article (original research)
DOI 10.1016/j.ijcard.2008.06.001
Open Access Status DOI
Volume 132
Issue 1
Start page 51
End page 58
Total pages 8
Editor Chuichi Kawai
Andrew J. S. Coats
Place of publication Amsterdam , The Netherlands
Publisher Elsevier
Language eng
Subject C1
321003 Cardiology (incl. Cardiovascular Diseases)
920103 Cardiovascular System and Diseases
110201 Cardiology (incl. Cardiovascular Diseases)
Formatted abstract
Background:
Many patients demonstrate psychological distress and reduced physical activity before coronary artery bypass graft surgery (CABG). Here we evaluated the addition of a brief, cognitive-behavioural intervention (the HeartOp Programme) to routine nurse counselling for people waiting for CABG surgery.

Methods:

Randomised controlled trial comparing nurse counselling with the HeartOp programme to routine nurse counselling in 204 patients
awaiting first time elective CABG. Primary outcome measures were: anxiety and length of hospital stay; secondary outcome measures were:
depression, physical functioning, cardiac misconceptions and cost utility. Measures were collected prior to randomisation and after 8 weeks
of their intervention prior to surgery, excepting length of hospital stay which was collected after discharge following surgery.

Results:

100 patients were randomised to intervention, 104 to control. At follow-up there were no differences in anxiety or length of hospital
stay. There were significant differences in depression (difference=7.79, p=0.008, 95% CI=2.04–13.54), physical functioning (difference=0.82, p=0.001, 95%CI=0.34–1.3) and cardiac misconceptions (difference=2.56, p<0.001, 95%CI=1.64–3.48) in favour of the HeartOp Programme. The only difference to be maintained following surgery was in cardiac misconceptions. The HeartOp Programme was found to have an Incremental Cost Effectiveness Ratio (ICER) of £288.83 per Quality-Adjusted Life Year.

Conclusions:

Nurse counselling with the HeartOp Programme reduces depression and cardiac misconceptions and improves physical
functioning before bypass surgery significantly more than nurse counselling alone and meets the accepted criteria for cost efficacy.
Keyword pre-operative care
coronary artery bypass
self-care
cognitive-behavioural treatment
Q-Index Code C1
Q-Index Status Provisional Code

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Nursing, Midwifery and Social Work Publications
 
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Created: Thu, 28 May 2009, 00:35:02 EST by Vicki Percival on behalf of School of Nursing, Midwifery and Social Work