Psychological assessment during cardiac rehabilitation

Depression and anxiety are common after myocardial infarction (MI) and cardiac surgery and may adversely affect outcome. A comprehensive cardiac rehabilitation service needs to include psychological input as well as education and exercise training. To address this issue the Bromley Hospitals NHS Trust (BHT) cardiac rehabilitation nursing team introduced the Hospital Anxiety and Depression Scale (HADS) into its cardiac rehabilitation service. Over a 21-week period, 130 patients attending a cardiac rehabilitation nursing assessment completed a HADS.

Audit of the HADS scores revealed that post-MI patients waiting longer than six months for cardiac rehabilitation had the highest levels of 'significant' anxiety (HADS score >10). Results suggest that timely entry into a cardiac rehabilitation programme helps to reduce the HADS scores of post-MI patients. The HADS was shown to be an effective tool for assessing the psychological wellbeing of patients attending cardiac rehabilitation. It enables those with significant anxiety and/or depression to be identified and offered further assessment by a cognitive behavioural therapist.