5819
document
Clinical implications of a reduction in psychological distress on cardiac prognosis in patients participating in a psychosocial intervention program . OBJECTIVE The objective of this secondary analysis was to examine the relationships between a reduction in psychological distress and long-term cardiac and psychological outcomes in post-myocardial infarction patients who participated in a randomized trial of home-based psychosocial nursing interventions ( the Montreal Heart Attack Readjustment Trial [ M-HART ] ) . Gender differences were considered . METHODS We studied 433 patients ( 36.0 % women ) from the M-HART treatment group who received two home visits after achieving a high psychological distress score ( ie , > or =5 ) on the General Health Questionnaire ( GHQ ) . Short-term GHQ success was determined by a return to a normal GHQ score ( < 5 ) or a reduction of > or =50 % after the two visits . Patients with short-term successful and unsuccessful GHQ outcomes were compared for mid-term maintenance of success , 1-year death and readmission rates , and 1-year depression and anxiety symptoms . RESULTS Patients with short-term GHQ success were more likely to show mid-term GHQ success ( p < .001 ) , marginally less likely to die of any causes ( p = .087 ) , less likely to die of cardiac causes ( p = .043 ) , less likely to be readmitted for any reason ( p < .001 ) and for cardiac reasons ( p < .001 ) , and less likely to have high depression ( p < .001 ) and anxiety ( p < .001 ) at 1-year than patients with short-term unsuccessful GHQ outcomes . Results held for men and women and were not altered by controlling for potential confounders . However , the number of deaths prevented analysis with statistical controls . CONCLUSIONS Post-myocardial infarction interventions that reduce psychological distress have the potential to improve long-term prognosis and psychological status for both men and women .
5820
Intervention_Educational
psychosocial intervention program
5821
Intervention_Educational
studied 433 patients ( 36.0 % women ) from the M-HART treatment group who received two home visits after achieving a high psychological distress score ( ie , > or =5 ) on the General Health Questionnaire ( GHQ )
5822
Outcome_Physical
GHQ success
5823
Outcome_Physical
GHQ score
5824
Outcome_Physical
mid-term GHQ success
5825
Outcome_Mortality
die of any causes
5826
Outcome_Mortality
die of cardiac causes
5827
Outcome_Physical
readmitted
5828
Outcome_Physical
high
5829
Outcome_Mental
depression
5830
Outcome_Mental
anxiety
5831
Outcome_Physical
GHQ outcomes
5832
Outcome_Mortality
deaths
5833
Outcome_Other
long-term prognosis
5834
Outcome_Other
psychological status
5835
Participant_Condition
psychosocial intervention program
5836
Participant_Condition
post-myocardial infarction
5837
Participant_Condition
Montreal Heart Attack
5838
Participant_Sample-size
433
5839
Participant_Sex
women
5840
Participant_Sex
men
5841
Participant_Sex
women
5842
Participant_Sex
men
5843
Participant_Sex
women