Family-focused cardiac rehabilitation. A role supplementation program for cardiac patients and spouses

A review of the literature yields general agreement among investigators regarding the responses of both patients and spouses to a cardiac event. Anxiety, depression, low self-esteem, marital and sexual dysfunction, and psychosomatic symptoms have been consistently documented up to 1 year following a myocardial infarction or cardiac surgery. Although the patient's physiologic status sets limits on the potential level of recovery, psychosocial variables are new recognized as playing a critical role in the rehabilitation process for both patients and their families. Our 3-year experience with patient-spouse groups supports the view that spouses must be involved throughout the rehabilitative process and that effective participation is provided within the context of a role supplementation program. Such a program facilitates direct and consistent communication as well as flexibility within and between roles. Both end points are critical to the re-establishment of family equilibrium and the ultimate recovery of the cardiac patient.