BACKGROUND:Many patients demonstrate psychological distress and reduced physical activity before coronary artery bypass graft surgery (CABG). Here we evaluated the addition of a brief, cognitive-behavioural intervention (the HeartOp Programme) to routine nurse counselling for people waiting for CABG surgery.
METHODS:Randomised controlled trial comparing nurse counselling with the HeartOp programme to routine nurse counselling in 204 patients awaiting first time elective CABG. Primary outcome measures were: anxiety and length of hospital stay; secondary outcome measures were: depression, physical functioning, cardiac misconceptions and cost utility. Measures were collected prior to randomisation and after 8 weeks of their intervention prior to surgery, excepting length of hospital stay which was collected after discharge following surgery.
RESULTS:100 patients were randomised to intervention, 104 to control. At follow-up there were no differences in anxiety or length of hospital stay. There were significant differences in depression (difference=7.79, p=0.008, 95% CI=2.04-13.54), physical functioning (difference=0.82, p=0.001, 95%CI=0.34-1.3) and cardiac misconceptions (difference=2.56, p<0.001, 95%CI=1.64-3.48) in favour of the HeartOp Programme. The only difference to be maintained following surgery was in cardiac misconceptions. The HeartOp Programme was found to have an Incremental Cost Effectiveness Ratio (ICER) of pound 288.83 per Quality-Adjusted Life Year.
CONCLUSIONS:Nurse counselling with the HeartOp Programme reduces depression and cardiac misconceptions and improves physical functioning before bypass surgery significantly more than nurse counselling alone and meets the accepted criteria for cost efficacy.
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【"Prehabilitation" prior to CABG surgery improves physical functioning and depression.].
【CABG手术前的“预适应”可改善身体机能和抑郁。】
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DOI：10.1016/j.ijcard.2008.06.001文章类型：杂志文章
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背景：许多患者在进行冠状动脉搭桥手术（CABG）之前表现出心理困扰和身体活动减少。在这里，我们评估了常规护士咨询中为等待CABG手术的人提供的简短的认知行为干预（HeartOp计划）。
方法：随机对照试验比较了204名初次选择CABG的患者中采用HeartOp计划进行的护士咨询与常规护士咨询的比较。主要结局指标为：焦虑和住院时间长短；次要结果指标是：抑郁，身体机能，心脏误解和费用效用。措施在随机分组之前和手术干预的8周后进行收集，但住院时间的长短是在手术后出院后收集的。
结果：100例患者被随机分为干预组，104例为对照组。随访时，焦虑或住院时间无差异。抑郁症（差异= 7.79，p = 0.008，95％CI = 2.04-13.54），身体功能（差异= 0.82，p = 0.001，95％CI = 0.34-1.3）和心脏误解（差异= 2.56）存在显着差异。 ，p <0.001，95％CI = 1.64-3.48）以支持HeartOp计划。手术后唯一要维持的区别是心脏误解。发现HeartOp计划每质量调整生命年的成本效益比（ICER）为288.83英镑。
结论：HeartOp计划的护士咨询比单独的护士咨询更能减少抑郁症和心脏误解，并改善旁路手术前的身体机能，并符合成本效益的公认标准。
方法：随机对照试验比较了204名初次选择CABG的患者中采用HeartOp计划进行的护士咨询与常规护士咨询的比较。主要结局指标为：焦虑和住院时间长短；次要结果指标是：抑郁，身体机能，心脏误解和费用效用。措施在随机分组之前和手术干预的8周后进行收集，但住院时间的长短是在手术后出院后收集的。
结果：100例患者被随机分为干预组，104例为对照组。随访时，焦虑或住院时间无差异。抑郁症（差异= 7.79，p = 0.008，95％CI = 2.04-13.54），身体功能（差异= 0.82，p = 0.001，95％CI = 0.34-1.3）和心脏误解（差异= 2.56）存在显着差异。 ，p <0.001，95％CI = 1.64-3.48）以支持HeartOp计划。手术后唯一要维持的区别是心脏误解。发现HeartOp计划每质量调整生命年的成本效益比（ICER）为288.83英镑。
结论：HeartOp计划的护士咨询比单独的护士咨询更能减少抑郁症和心脏误解，并改善旁路手术前的身体机能，并符合成本效益的公认标准。
