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(Ivanhoe Newswire) -- Depressive symptoms improved among women with coronary heart disease who participated in a motivationally-enhanced cardiac rehabilitation program exclusively for women.
Depression often occurs with heart disease and is more likely to affect women than men. Depression interferes with adherence to lifestyle modifications and the willingness to attend rehabilitation.
"Women often don't have the motivation to attend cardiac rehab particularly if they're depressed," lead author Theresa Beckie, Ph.D., professor at the University of South Florida's College of Nursing in Tampa, FL, was quoted as saying. "Historically women have not been socialized to exercise, and their attendance in cardiac rehabilitation programs has been consistently poor over the last several decades. This poor attendance may be partly due to mismatches in stages of readiness for behavior change with the health professional approaching from an action-oriented perspective . . . this is destined to evoke resistance."
Cardiac rehabilitation programs tailored to the needs of women and to their current level of readiness to change may improve adherence to such programs and potentially improve outcomes for women, said Beckie.
The 5-year randomized clinical trial studied physiological and psychosocial outcomes of women who participated in a 12-week stage-of-change-matched, motivationally enhanced, gender-tailored cardiac rehabilitation program exclusively for women and compared them with outcomes for women who attended a 12-week traditional cardiac rehabilitation program comprised of education and exercise.
Participants completed the 20-item Center for Epidemiological Studies Depression Scale prior to beginning the intervention, one week after completing the intervention, and again six months later. The questionnaire asked them about how often in the past week they felt depressed, hopeful, lonely, happy and fearful.
Depression scores for women in traditional cardiac rehab dropped from 16.5 to 14.3 in 12 weeks, while scores in the augmented group dropped from 17.3 to 11.0 "a significant decline compared to the traditional group," said Beckie.
After a six-month follow-up, the traditional rehab group had an average score of 15.2 and those in the women-specific program had an average score of 13. Beckie said, "We found that improvements in depressive symptoms were sustained at the six-month follow-up in the augmented group while those in traditional cardiac rehab were essentially unchanged. This intervention also led to significantly better attendance and completion rates than those in the traditional cardiac rehabilitation program."
"We didn't push them if they weren't ready to make the changes," Beckie said. "Pushing such patients who are not ready can lead them to tune out or drop out. Instead, for these women, we acknowledged their ambivalence about change and gave them strategies to move toward being ready by reinforcing their own motivations for changing. It's unrealistic to expect all patients to change their lifestyle all at once, right now in front of you. . . . You can't treat everyone the same when it comes to changing health behaviors."
SOURCE: Presented at the American Heart Association's Scientific Sessions, November 2009
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