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The Influence of Cognitive, Affective, and Somatic Symptoms of Depression and Related Psychosocial Variables on Cardiovascular Rehabilitation Participation

by John Taylor Freeman

Institution: East Carolina University
Year: 2017
Keywords: Attendance; Heart Diseases Patients Rehabilitation; Patient participation; Depression, Mental; Mental health
Posted: 02/01/2018
Record ID: 2154135
Full text PDF: http://hdl.handle.net/10342/6123


Abstract

Background: Cardiac rehabilitation (CR) has been shown to be an efficacious part of disease management to reduce negative outcomes associated with a variety of cardiovascular diseases (CVDs). Despite the significant amount of research support, participation rates in CR programs remain suboptimal. While a plethora of research exists which examines potential reasons for the lack of participation, there are still factors which have yet to be fully examined. For example, while depression has been associated with reduced CR participation, this association has not been fully explored in the literature and some related psychological factors may also be key contributors to the lack of participation in CR. Purpose: The current research seeks to explore the impact of depression and related psychosocial variables on CR participation. By examining specific symptom clusters of depression and related variables, such as negative illness cognitions and depressive behaviors, the relation between depression and CR participation can be more fully understood. Methods: 56 patients at a local CR center were asked to complete a set of questionnaires assessing depressive symptoms, negative illness cognitions, and depressive behaviors as soon as possible during their CR program. Then, their progress was tracked through CR and the number of sessions and completion status of the participants was recorded after they finished the program. Relevant demographics were also analyzed to attempt to determine what may have the greatest impact on CR participation rates. Results: Results from this study suggested that there was not a significant association between depressive symptom clusters, negative illness cognitions, or depressive behaviors and the outcomes of number of sessions attended or CR completion status. Participant age was a significant predictor of both outcomes, however, which indicated that younger CR patients attended fewer sessions and were less likely to complete the program than older patients. In some analyses, education level was also a significant predictor of CR participation rates, with those having a college degree or higher attending more sessions than those without a college degree. Discussion: The current research found that there was not a significant association between specific symptoms of depression or related variables and CR participation. Given that these results are not entirely consistent with previous literature in this area, it is possible that methodological limitations hindered the study's ability to fully address the research question. However, the complicated findings in the literature and continued poor rates of participation in CR programs suggests that more research is needed in this area and the relation between depression and CR participation should continue to be evaluated.

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