Demographic differences in religious coping after a first-time cardiac event.

PURPOSE: The purpose of this project was to describe demographic characteristics of patients who may use religion as a coping response to a first-time cardiac event. METHODS: Patients (N = 105), who were enrolled in cardiac rehabilitation after a first-time myocardial infarction or coronary artery revascularization bypass surgery, completed the Religious Coping Activities Scale. Independent variables included age, gender, religious affiliation, diagnosis, marital status, and education level. The 6 types of religious coping activities were compared for each level of the independent variables. RESULTS: Significant differences emerged for gender, religious affiliation, marital status, and level of education. Women scored higher than men on spiritually based activities (T = 1550, P = .03), good deeds (T = 1504, P = .08), and religious avoidance coping (T = 1505, P = .08). Participants who claimed no religious affiliation scored lowest on good deeds (H[2] = 9.7, P = .008) and interpersonal religious support coping (H[2] = 13.4, P = .001) and higher on discontent coping (H[2] = 5.4, P = .07). Single participants scored higher on spiritually based coping than did married participants (T = 1251, P = .04) and lower on discontent coping (H[1] = 4.3, P = .04). Plead coping was an inverse function of education (H[3] = 6.8, P = .08). CONCLUSIONS: Patients beginning cardiac rehabilitation, particularly those with the demographic characteristics discussed in this study, may benefit from assessment of their desire for pastoral intervention.

Cardiac rehabilitation outcomes no different after on-pump versus off-pump coronary artery bypass surgery.

PURPOSE: Clinical evidence supports lower morbidity with off-pump coronary revascularization surgery as well as superior short- and mid-term outcomes, equivalent graft patency, and reduced cost. The purpose of this study was to compare cardiac rehabilitation (CR) outcomes between patients undergoing on-pump versus off-pump coronary artery bypass surgery. METHODS: Data were retrospectively examined for patients who participated in CR between 1996 and 2004. Two hundred ninety-five patients who underwent bypass surgery and completed at least 80% of their 36 required sessions were divided into on-pump and off-pump groups. Pre- and post-CR measures included grip strength, flexibility, energy expended during class, quality of life, and self-efficacy. RESULTS: Both groups were similar with respect to age, sex, ejection fraction, and mean number of grafts. There were no statistical differences between the on-pump and off-pump groups (P > .05) for weight, abdominal and hip circumferences, grip strength, flexibility, and total energy expenditure. In addition, there were no between-group differences regarding quality of life and self-efficacy. Grip strength, flexibility, and energy expenditure during class improved with CR regardless of the surgical procedure (P = .001). Quality of life (P = .001) and self-efficacy (P = .001) also improved. CONCLUSIONS: The present data support the concept that although there are clinical advantages to off-pump surgery, there is no benefit over on-pump surgery regarding CR. Subsequently, patients undergoing off-pump surgery should be managed similarly as their on-pump counterparts.

Quality of life and self-efficacy: gender and diagnoses considerations for management during cardiac rehabilitation.

PURPOSE: Outcome measurement research has extended beyond traditional clinical and physiologic parameters to include psychosocial aspects. Accordingly, the purpose of this study was to investigate quality-of-life (QOL) and self-efficacy disparities for gender and diagnoses during participation in cardiac rehabilitation. METHODS: For this study, 472 patients (114 women and 358 men) were stratified by gender and then again by diagnosis to include surgical revascularization, myocardial infarction, and percutaneous coronary intervention. Measures obtained at baseline and at the end of the study assessed quality of life (QOL-o = total score), including emotional (QOL-e) and limitation (QOL-l) domains; self-efficacy (SE-o = total score), including ambulatory (SE-a) and muscular (SE-m) domains; and caloric expenditure. RESULTS: Both self-efficacy and QOL were greater at the end of the study across genders (P <.05). The men had greater self-efficacy values for all domains (P <.05). There was a significant gender-time interaction for QOL-e (P <.05) among the women, and for QOL-o, QOL-l, and all self-efficacy domains (P <.05) among the surgical revascularization patients. Percutaneous coronary intervention patients had higher self-efficacy scores throughout. Caloric expenditure was a consistent positive predictor of self-efficacy and QOL-e (P <.05). CONCLUSIONS: Quality of life and self-efficacy improve during cardiac rehabilitation across gender and diagnoses. Female and revascularized patients present with low QOL and self-efficacy scores initially, but improvements in scores similar to or greater than the men can be expected. Because the self-efficacy scores of percutaneous coronary intervention patients are higher and their physical limitations are less prohibitive, these patients can be progressed more aggressively. Improvements in self-efficacy scores parallel caloric expenditure increases.

Quality of Life and Self Efficacy in Cardiac Rehabilitation Patients Over 70 Years of Age Following Acute Myocardial Infarction and Bypass Revascularization Surgery.

Does 12 weeks of cardiac rehabilitation improve quality of life and self efficacy in patients greater than 70 years of age following an acute myocardial infraction or bypass surgery? Three hundred forty four patients were divided into an Older group (70-89 years of age; n equals 122) and a younger group (50-69 years of age; n equals 222). Two hundred fifteen had bypass surgery (Surgical group) and 129 had a myocardial infarction (MI group). Quality of life emotions domain was greater for the Older group at week 12 (p equals 0.066). The Surgical group had greater increases in overall quality of life and quality of life limitations domain (p equals 0.012; p is less than 0.001). Self efficacy scores were greater for the Younger group. MI group had greater self efficacy at week 1, while the Surgical group was greater at week 12 (p is less than 0.001). These results suggest age and diagnosis related differences in quality of life and self efficacy. (c) 2000 by CVRR, Inc.