Quality of life measures and gender comparisons in North Carolina Cardiac Rehabilitation Programs

Quality of life (QOL) is an important health-related outcome measure in patients with cardiovascular disease. The North Carolina Cardiopulmonary Rehabilitation Association (NCCRA) is a coalition of 72 state-certified, multidisciplinary cardiac rehabilitation (CR) programs. In 1997, the NCCRA Executive Board and Research Committee agreed to collect ongoing data to assess QOL changes following CR participation using the Ferrans & Powers QOL Index Cardiac Version III. The purpose of this study was to determine if changes were present in QOL scores after 12 weeks of CR in men and women from multiple outpatient centers.

Data were analyzed from 420 patients from 19 Phase II early outpatient CR programs who completed the QOL index survey within the first week of program entry and upon discharge. The four QOL index domains measured were health/function, psychological/spiritual status, socioeconomic status, and family interaction. Overall QOL was tabulated as the aggregate score from the four domains. Each domain, as well as overall QOL, was compared pre- and post-CR participation with a repeated measures analysis of variance.

Across programs, statistically significant improvements in QOL indices were observed following 12 weeks of CR in each of the four domains and on the overall score in all patients. Men reported greater CR entry and discharge scores than women on the health/function, family interaction, and overall scores. Women showed a greater positive change in scores than men on the socioeconomic, family interaction, and overall scores.

Patients who participated in Phase II multidisciplinary North Carolina CR programs and completed the protocol improved QOL parameters. While men had higher physical function and overall QOL scores both pre- and post-CR, women showed greater improvements in overall scores, as well as in family and socioeconomic parameters. These findings suggest that North Carolina CR patients experience a positive change in QOL following short-term participation in CR. Further study with a larger number of patients benchmarked with programs from other regions with comparisons to patients who do not participate in formalized CR programs is indicated from this investigation.