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Question: What psychological and social (carers) support best aids people after MI to reduce their risk of subsequent cardiac problems and to promote their return to a full and normal life?
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Grading: 2+ Well-conducted case–control or cohort studies with a low risk of confounding, bias or chance and a
Reference number 2999
O'Rourke A;Hampson SE;
Psychosocial outcomes after an MI: an evaluation of two approaches to rehabilitation
19994Psychology Health & Medicinepgs 393 402
Study Type: Cohort
Patient Characteristics Consecutive first time post MI patients, age < 76 years, speak / read English.
Intervention Hospital 1: Edinburgh Heart Manual. Self-help rehabilitation program incorporating education, exercise and stress management components with follow-ups at 1, 3 and 6 weeks post MI by a trained facilitator.
Comparisons Hospital 2: Usual care.
Study Length 6 months.
Outcomes Significant Others Scale (SOS), Recovery Locus of Control Scale (RLOC), Generalised Self-Efficacy Scale (GSES), Illness Perception Questionnaire (IPQ), Hospital Anxiety and Depression Scale (HAD), Health Service Utilization.
Funding Not listed.
Effect There was a significant interaction between group (hospital 1 versus hospital 2) and time (baseline versus 6 months) for perceptions of control over the illness (F(1,45) = 4.14, P < 0.05, effect size 0.08) and depression (F(1,53) = 6.55, P < 0.01, effect size 0.11). Controlling for baseline differences, patients in hospital 1 had significantly higher perceptions of control over their illness and lower levels of depression compared with patients in hospital 2. No significant differences were found between groups for either hospital admissions or GP contact.

From: Appendix C, Clinical Evidence Extractions

Cover of Post Myocardial Infarction
Post Myocardial Infarction: Secondary Prevention in Primary and Secondary Care for Patients Following a Myocardial Infarction [Internet].
NICE Clinical Guidelines, No. 48.
National Collaborating Centre for Primary Care (UK).
Copyright © 2007, National Collaborating Centre for Primary Care.

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