Brief psychological intervention in phase I of cardiac rehabilitation after acute coronary syndrome

Acute coronary syndrome (ACS) is an important cause of mortality and significant personal and financial costs. Cardiac rehabilitation (CR) programs have shown positive effects in reducing cardiovascular mortality and improving functional capacity. However, adherence is low and appears to be influenced by psychosocial factors, such as patients’ cognitions and emotional state. The objective was to evaluate the efficacy of a brief in-hospital psychological intervention to promote cognitive and emotional adaptation after ACS. One hundred and twenty-one patients with ACS, admitted to a coronary care unit in a central hospital, were randomized to an experimental group (EG, n=65) and a control group (CG, n=56). Portuguese versions of the HADS and BIPQ were used to measure emotional well-being and illness cognitions. Two 1 h 15 min sessions were conducted 2-3 days after hospital admission, and a 20-minute follow-up session took place one month after discharge. Patients were assessed at four different time points: pre-test, post-test, and at 1- and 2-month follow-up. The intervention had significant effects on anxiety, depression and illness cognitions. Anxiety and depression were significantly reduced and illness cognitions improved significantly in the EG compared to the control group. For the EG, these changes were maintained or enhanced at 1- and 2-month follow-up, whereas for the CG there was a deterioration in psychosocial adjustment. These results indicate that a brief psychological intervention program delivered during hospitalization for ACS and combined with standard medical care can have positive effects in terms of psychosocial outcomes that have proven impact on cardiac rehabilitation and prognosis. A síndroma coronária aguda (SCA) é uma importante causa de mortalidade, com custos pessoais e financeiros consideráveis. Os programas de reabilitação cardíaca têm benefícios na redução da mortalidade e melhoria da capacidade funcional. Contudo, a adesão é baixa e depende de fatores como o estado emocional e as representações de doença. Neste trabalho, avaliou-se a eficácia de um programa de intervenção psicológica breve na fase I da reabilitação cardíaca da SCA. Cento e vinte e um doentes com SCA, admitidos na unidade coronária de um hospital central, foram aleatorizados num grupo experimental (GE) (n= 65) e num grupo de controlo (GC) (n=56). Foram utilizadas versões portuguesas da HADS e IPQ-B para avaliar a adaptação emocional e as representações de doenç