[Significance of the social anamnesis in the rehabilitation of coronary patients]. / Zur Bedeutung der Sozialanamnese bei der Rehabilitation von Koronarkranken.

We studied some indicators of the course of the disease in male patients (N = 45; x age = 46 +/- 5.6 years) who after first myocardial infarction (MI) spent 4-6 weeks in a rehabilitation clinic. The investigation is done to test the following hypotheses: 1. Social distress during the preinfarction phase is related to coping with the disease (namely anxiety) and to some risk factors (overweight, low-density-Lipoprotein). 2. Participation in a stress-management training that aims at enhancement of coping with social distress has positive effects on the course of the disease. This is particularly true in those who are under strong social pressure. Two panel waves, at the beginning and at the end of stationary rehabilitation, where we gathered data on social and standard risk factors, confirmed our hypotheses in part. Anxiety after MI was related to social distress before MI. For both, anxiety and low-density-lipoprotein, we found a significant interaction effect of social distress and stress-management training as a result of a multivariate analysis of variance (MANOVA; SPSS). Given the small sample size the results should be taken as preliminary and should not be overinterpreted.

[The psyche and cardiac infarct]. / Psyche und Herzinfarkt.

The psychosocial aspects of coronary heart disease before the first myocardial infarction (coronary-prone behaviour in interaction with chronic social risk situations and subacute life events) and the psychic reactions of patients after heart attack (anxiety, depression, denial and overmotivation as a coping strategy) are discussed. Answers are proposed for the following practical questions: Are psychosocial stressors as predictors of coronary disease scientifically documented and accepted as are the traditional risk factors? Must the psychosocial aspects of coronary disease be integrated in new ways into the management of myocardial infarction (comprehensive coronary care) in order to improve prognosis and quality of life for the patient and his family?

[Current status of ambulatory coronary groups in West Germany. Results of a nation-wide survey]. / Die aktuelle Situation in den ambulanten Koronargruppen der Bundesrepublik Deutschland. Ergebnisse einer bundesweiten Umfrage.

The aim of the study was to gather detailed information on the structure and function of ambulatory coronary training groups in Germany by means of a nationwide survey. The response rate was 66.7%; the results are therefore representative for the FRG. From the collected data it can be estimated that approximately 500 coronary clubs care for approximately 9 000 patients. Sponsorship, financing, group structure, and club activities, as well as data on morbidity and complications, are presented in detail. Statements by both physicians and patients support the view that the main benefit of coronary clubs is not the improvement of physical fitness, but the improvement in the quality of life of the participants.

[Rehabilitation in ambulatory coronary groups]. / Rehabilitation in ambulanten Koronar-Gruppen.

In Western Germany anti-coronary clubs are a relatively new form of organized rehabilitation and secondary prevention after myocardial infarction. At the present time there are operating about 120 such groups, sponsored by hospitals, sports clubs, groups of family doctors, educational organizations and patient selfhelping groups. The groups divided in "good risk", "bad risk" and "preventive" group play an important role in a comprehensive rehabilitation program. Their aims are: changing the risk factors and life style, easing anxiety, depressions, denial and overmotivation, improving life quality, reintegrating the patients into social life, improving physical fitness. Multicenter studies are necessary to find out, if Anticoronary Clubs are able to lower the mortality rate and the reinfarction morbidity.

[Problems in nonsmoker training]. / Probleme des Nichtraucher-Trainings

As results of long experiences with patients who urgently need to stop smoking and in group therapy the practical problems of such trials are discussed: the different reasons and problems for addicts and habitual smokers, "pseudoalibis", analysis of the predominant motivation, the different steps of cessation and the problems of the ex-smoker in his surroundings.