Effects of a telephone counseling intervention on psychosocial adjustment in women following a cardiac event

Publication Type:
Journal Article
Citation:
Heart and Lung: Journal of Acute and Critical Care, 2003, 32 (2), pp. 79 - 87
Issue Date:
2003-01-01
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OBJECTIVE: The purpose of this study was to test the effect of a post-discharge telephone counseling intervention on women's psychosocial adjustment following a cardiac event. DESIGN: The study was a prospective, randomized, controlled trial. PATIENTS: Women (n = 196) were recruited from 4 hospitals in Sydney, Australia, who were hospitalized for coronary artery disease: myocardial infarction, coronary artery bypass grafts, coronary angioplasty, or stable angina. Women were randomized to usual care (n = 103) or telephone counseling (n = 93) and were 67 years of age (range 34-92). The majority had not completed high school (92%) and were not employed (84%). OUTCOMES: Psychosocial adjustment was measured by the Psychosocial Adjustment to Illness Scale and the Hospital Anxiety and Depression Scale the day before hospital discharge and 12 weeks postdischarge. INTERVENTION: Individualized information and support, was designed to promote self-managed recovery and psychosocial adjustment, and began with an evaluation during admission and was followed up by telephone counseling at 1, 2, 3, and 6 weeks after discharge. RESULTS: The intervention had no effect on psychosocial adjustment (F[1, 182] = 0.06, P = .8), anxiety (F[1,182] = 0.15, P = .69) or depression (F[1, 182] = 0.11, P = .74) at 12 weeks after discharge. Women made significant improvements during the 12 weeks on mean scores for psychosocial adjustment (F[1, 182] = 58.37, P = .00), anxiety (F [1, 182] = 74.58, P = .00) and depression (F[1, 182] = 14.11, P = .00). The predictors of poor psychosocial outcomes for women included being less than 55 years of age, being unemployed or retired, having poor psychosocial adjustment to illness at baseline, having read-mission, or experiencing a stressful, personal event during follow-up. CONCLUSIONS: Women at risk for poor outcomes following hospitalization for a cardiac event can be identified (ie, women less than 55 years of age, unemployed or retired, poorly adjusted to their cardiac illness, or readmitted to hospital within 12 weeks of a previous cardiac admission), but an effective intervention to enhance psychosocial outcomes remains to be established.
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