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document
Psychosocial nursing therapy following sudden cardiac arrest : impact on two-year survival . BACKGROUND Although psychosocial therapy has been shown to reduce mortality after myocardial infarction , it is unknown whether the benefits of psychosocial therapy on mortality reduction extend to out-of-hospital sudden cardiac arrest , a main cause of cardiovascular mortality . OBJECTIVE Describe efficacy of psychosocial therapy on two-year cardiovascular mortality in sudden cardiac arrest survivors . METHOD Survivors of out-of-hospital ventricular fibrillation or asystole ( N = 129 ) , documented by electrocardiograms from registries of a citywide Medic One unit and two countywide emergency units , were randomized into a two group , experimental , longitudinal design . The intervention consisted of 11 individual sessions , implementing three components : physiologic relaxation with biofeedback training focused on altering autonomic tone ; cognitive behavioral therapy aimed at self-management and coping strategies for depression , anxiety , and anger ; and cardiovascular health education . The primary outcome measure was cardiovascular mortality . RESULTS Risk of cardiovascular death was significantly reduced 86 % by psychosocial therapy , p = .03 . Six of the seven cardiovascular deaths in the control group were caused by ventricular arrhythmias . The cardiovascular death in the therapy group was due to stroke . Controlling for depression , previous myocardial infarction , low ejection fraction , decreased heart rate variability , and ventricular ectopic beats had little impact on estimated treatment effect . The risk of all-cause mortality was reduced by 62 % in the therapy group , p = .13 . There were a total of three deaths in the therapy group and eight deaths in the control group . CONCLUSIONS Psychosocial therapy significantly reduced the risk of cardiovascular death in sudden cardiac arrest survivors .
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Intervention_Psychological
Psychosocial nursing therapy
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Intervention_Educational
psychosocial therapy
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Intervention_Educational
psychosocial therapy
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Intervention_Psychological
psychosocial therapy
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Intervention_Psychological
cognitive behavioral therapy
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Intervention_Control
control
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Intervention_Psychological
Psychosocial therapy
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Outcome_Mortality
two-year survival
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Outcome_Mortality
mortality
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Outcome_Mortality
mortality reduction
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Outcome_Mortality
cardiovascular mortality
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Outcome_Mortality
cardiovascular mortality
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Outcome_Mortality
cardiovascular mortality
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Outcome_Mortality
Risk of cardiovascular death
5928
Outcome_Mortality
cardiovascular deaths
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Outcome_Mortality
The cardiovascular death
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Outcome_Physical
depression , previous myocardial infarction , low ejection fraction , decreased heart rate variability , and ventricular ectopic beats
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Outcome_Mortality
risk of all-cause mortality
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Outcome_Mortality
deaths
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Outcome_Mortality
deaths
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Outcome_Mortality
cardiovascular death
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Participant_Condition
following sudden cardiac arrest :
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Participant_Condition
sudden cardiac arrest survivors .
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Participant_Sample-size
129