The Impact of a Cardiac Rehabilitation Program and Gender on Depressive Symptoms in Cardiac Patients

Abstract

A cardiac event affects the physical and psychological well being of individuals. Among the psychological consequences, researchers have found that a cardiac event can lead to high levels of depressive symptoms in both males and females (Milani, Lavie, & Cassidy, 1996). To date, research has confirmed the beneficial effects of a cardiac rehabilitation (CR) program on depressive symptoms (Casey, Hughes, Waechter, Josephson, & Rosneck, 2008; Zellweger, Osterwalder, Langewitz, & Pfisterer, 2004); however, there has been a limited focus on how males and females differ in their depressive symptoms both prior to commencing and after completing a CR program. Previous research has shown that patients with heart disease and co-morbid depressive symptoms have a high risk for subsequent major cardiac events and potentially fatal cardiac consequences (Irwin, Artin, & Oxman, 1999). This can place a significant economic burden on society, lead to treatment drop-out and program non-compliance, and reduce the overall well-being of the patient (Tylee & Gandhi, 2005). However, understanding the impact of a CR program on depressive symptoms may reduce these health risks. Therefore, the purpose of this study was to examine the effect of a CR program on depressive symptoms in male and female heart disease patients after a cardiac event. The study used secondary data based on the treatment of a twelve-week, physician supervised, community-based CR program. Responses from 272 participants (178 men and 94 women) who completed the center for epidemiological studies depression (CES-D) scale questionnaire were collected twice over the course of the rehabilitation program (at baseline and twelve weeks). Although previous research has shown that females have an increased susceptibility to depressive symptoms in both the cardiac and general population (Lindwall, Stain-Malmgren, Andersson, Aberg-Wistedt, & Schenck-Gustafsson, 2007), the female participants in this study did not score higher than males for depressive symptoms at the start or at the completion of the CR program. Moreover, male and female participants did not possess a high score for depressive symptoms at the start of the CR program or after completing the program; despite preceding studies that indicate a high score for depressive symptoms at the commencement of a CR program and an overall improvement in depressive symptoms over the course of a CR program (Milani & Lavie, 2007; Shepherd & While, 2012). It is also worth noting that only 35% of the sample were women. In order to understand some of reasons why the participants in this study did not show signs of depressive symptoms, there needs to be additional questions that address barriers to participation in cardiac rehabilitation as part of the questionnaires that are already in place. Moreover, to ensure that attendance in cardiac rehabilitation is effective and immediate, there needs to be more efficient strategies that allow for continued contact between the health care provider and the cardiac patient.