Psychological Distress Affects Performance during Exercise-Based Cardiac Rehabilitation

Area of Science:

• Cardiology
• Psychology
• Rehabilitation Medicine

Background:

• Psychosocial distress is a known factor influencing morbidity and mortality in cardiovascular disease patients.
• The impact of psychological distress on cardiovascular performance in post-cardiac surgery patients undergoing rehabilitation requires further investigation.

Purpose of the Study:

• To investigate the relationship between psychological distress and cardiovascular performance in patients after cardiac surgery.
• To identify specific psychological factors that may impede recovery and functional improvement during cardiac rehabilitation.

Main Methods:

• Fifty-seven post-cardiac surgery patients completed the Symptom Checklist-90-Revised (SCL-90-R) and 12-item General Health Questionnaire (GHQ-12) within five days of admission.
• Cardiovascular performance was assessed using the 6-minute walking test (6MWT) and derived maximal oxygen consumption (VO2 max) at admission and discharge.
• The Positive Symptom Distress Index (PSDI) was used to quantify symptom distress levels.

Main Results:

• A high prevalence of psychological distress was observed, with over-represented somatic, depressive, anxiety, phobic anxiety, and psychoticism symptoms.
• 75.4% of patients reported a negative perception of their health status on the GHQ-12.
• Inverse correlations were found between improvements in 6MWT and VO2 max with SCL depression, PSDI, and GHQ-12 scores, indicating that higher distress was linked to poorer performance gains.

Conclusions:

• Cardiac rehabilitation post-surgery was associated with increased psychological distress compared to the general population.
• The severity of psychological distress, depression, and hostility significantly limits functional performance improvements.
• Integrating psychological support into cardiac rehabilitation programs is crucial for optimizing patient recovery and outcomes.