The Effectiveness of Cognitive-Behavioral Therapy on Perceived Stress and Coping Skills in Patients after Myocardial Infarction

Document Type : Original Article

Authors

1 Department of Psychology, Rasht Branch, Islamic Azad University, Rasht

2 Department of Psychology, Tonekabon Branch, Islamic Azad University, Tonekabon, Iran.

3 Cardiovascular diseases research center, Department of cardiology, Heshmat Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran

Abstract

Introductoin: Acute myocardial infarction is one of the most common causes of admissions and referral in cardiovascular patients. In addition to physiological reasons, psychological factors play a key role in the onset and exacerbation of the disease. The purpose of this study was to evaluate the effectiveness of cognitive-behavioral therapy on perceived stress and coping skills in patients after myocardial infarction.
Method: The present study was a clinical trial based on the experimental design (pre-test, post-test with control, and follow-up group). The statistical population of the study was included 30 discharged patients with a diagnosis of myocardial infarction who referred to the Noor specialized Heart clinic in Rasht in 2018. The patients were divided into experimental (5 females and 10 males) and control groups (8 females and 7 males) with a simple random sampling method. Assessment tools included perceived stress and coping strategies questionnaires that were completed pre, post, and 3 months after the intervention. The experimental group was conducted to educate within eight 90min weekly sessions for two months. Data were analyzed using independent t-test, repeated measures analysis of variance, and Bonferroni test.
Results: The results showed that Cognitive-Behavioral Therapy had a significant difference in the mean perceived stress (F=10.8, p< 0.05), problem solving strategy (F=10.10, p<0.001), and emotion-focused strategy (F=3.43, p<0.05) in the experimental group compared to control group was observed.
Discussion and Conclusion: Cognitive-behavioral intervention is effective on perceived stress and coping skills in patients after myocardial infarction

Keywords


  1. Ibanez B, James S, Agewall S, Antunes MJ, Bucciarelli-Ducci C, Bueno H, et al. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC). European heart journal. 2018;39(2):119-77.
  2. Thygesen K, Alpert JS, Jaffe AS, Chaitman BR, Bax JJ, Morrow DA, et al. Fourth Universal Definition of Myocardial Infarction (2018). Journal of the American College of Cardiology. 2018;72(18):2231-64.
  3. Ebrahimi K, Khadem Vatan K, Salarilak S, Gharaaghaji R. Epidemiological features of risk factors occurrence and outcomes of myocardial infraction in patients admitted to hospitals in west azerbaijan province during the years 2011 and 2012. Urmia Medical Journal. 2015;26(8):724-34.
  4. Jani M, Salehi B, Aleyasin SA, Davoudi H. The Effectiveness of Cognitive Behavioral Group Therapy on Quality of Life of Cardiovascular Patients. Journal of Arak University of Medical Sciences. 2017;20(3):22-30.
  5. Lilly LS, Braunwald E. Braunwald's heart disease: a textbook of cardiovascular medicine: Elsevier Health Sciences; 2012.
  6. Torpy JM, Burke AE, Glass RM. Coronary heart disease risk factors. Jama. 2009;302(21):2388-.
  7. Pereira MG, Figueiredo AP, Fincham FD. Anxiety, depression, traumatic stress and quality of life in colorectal cancer after different treatments: a study with Portuguese patients and their partners. European Journal of Oncology Nursing. 2012;16(3):227-32.
  8. Díaz-Morán S, Palència M, Mont-Cardona C, Cañete T, Blázquez G, Martínez-Membrives E, et al. Coping style and stress hormone responses in genetically heterogeneous rats: comparison with the Roman rat strains. Behavioural brain research. 2012;228(1):203-10.
  9. Karlsen B, Oftedal B, Bru E. The relationship between clinical indicators, coping styles, perceived support and diabetes‐related distress among adults with type 2 diabetes. Journal of advanced nursing. 2012;68(2):391-401.
  10. De la Roca-Chiapas JM, Solís-Ortiz S, Fajardo-Araujo M, Sosa M, Córdova-Fraga T, Rosa-Zarate A. Stress profile, coping style, anxiety, depression, and gastric emptying as predictors of functional dyspepsia: a case-control study. Journal of psychosomatic research. 2010;68(1):73-81.
  11. LePine MA, Zhang Y, Crawford ER, Rich BL. Turning their pain to gain: Charismatic leader influence on follower stress appraisal and job performance. Academy of Management Journal. 2016;59(3):1036-59.

12-امیرفخرایی, آزیتا. اثربخشی مقدماتی درمان شناختی-رفتاری بر اختلال نعوظ جنسی و شدت علائم روان‌شناختی همبود: پژوهش مورد منفرد. روانشناسی بالینی و شخصیت. 2020;16(2):17-27.

  1. Shin H, Park YM, Ying JY, Kim B, Noh H, Lee SM. Relationships between coping strategies and burnout symptoms: A meta-analytic approach. Professional Psychology: Research and Practice. 2014;45(1):44.

14-پایدار اع, سلاله‌سادات, خدابخش, روشنک, مهری‌نژاد, ابوالقاسم س. مقایسه اثربخشی درمان شناختی–رفتاری و فراشناختی بر درهم‌آمیختگی فکر بیماران مبتلابه وسواس فکری–عملی. روانشناسی بالینی و شخصیت. 2020;16(2):41-51.

  1. Jeyanantham K, Kotecha D, Thanki D, Dekker R, Lane DA. Effects of cognitive behavioural therapy for depression in heart failure patients: a systematic review and meta-analysis. Heart failure reviews. 2017;22(6):731-41.
  2. Norlund F, Wallin E, Olsson EMG, Wallert J, Burell G, von Essen L, et al. Internet-based cognitive behavioral therapy for symptoms of depression and anxiety among patients with a recent myocardial infarction: the U-CARE heart randomized controlled trial. Journal of medical Internet research. 2018;20(3):e88.
  3. Greenman P, Jetté J, Green-Demers I, Grenier J. Sad and worried hearts: a psychological treatment for clinically significant depression, anxiety, and post-traumatic stress in patients with cardiac disease. Int J Clin Cardiol. 2015;2:037.
  4. Oladi F, Bayazi MH, Dargahi M, DEHGHANI NM. Cognitive Behavioral Group Therapy and Coping Styles in patients with Acute Coronary Heart Disease. 2014.
  5. Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. Journal of health and social behavior. 1983:385-96.
  6. Safaei M, Shokri O. Assessing stress in cancer patients: Factorial validity of the perceived stress scale in Iran. 2014.
  7. Lazarus RS, Folkman S. Stress, appraisal, and coping: Springer publishing company; 1984.
  8. Nedaei A, Paghoosh A, Sadeghi-Hosnijeh A. Relationship between coping strategies and quality of life: Mediating role of cognitive emotion regulation skills. Scientific Journal Management System. 2016;4(8):35-48.
  9. Arnold SV, Smolderen KG, Buchanan DM, Li Y, Spertus JA. Perceived stress in myocardial infarction: long-term mortality and health status outcomes. Journal of the American College of Cardiology. 2012;60(18):1756-63.
  10. Akbari M, Mahmood Aliloo M, Aslanabadi N. Relationship between stress and coping styles with coronary heart disease: Role of gender factor. Iranian Journal of Psychiatry and Clinical Psychology. 2010;15(4):368-76.
  11. Brantley PJ, Grothe KB, Dutton GR. Stress, anger, and hostility in coronary heart disease. Formulation and Treatment in Clinical Health Psychology: Routledge; 2009. p. 118-36.
  12. Heidari Pahlavian A, Gharakhani M, Mahjub H. A comparative study of stressful life events and stress coping strategies in coronary heart disease patients and non-patients. Avicenna Journal of Clinical Medicine. 2010;17(3):33-8.
  13. Smith TW, Ruiz JM. Psychosocial influences on the development and course of coronary heart disease: current status and implications for research and practice. Journal of consulting and clinical psychology. 2002;70(3):548.
  14. Sadock BJ, Sadock VA, Levin Ze. Kaplan and Sadock's study guide and self-examination review in psychiatry: Lippincott Williams & Wilkins; 2007.
  15. Dolan SL, Martin RA, Rohsenow DJ. Self-efficacy for cocaine abstinence: Pretreatment correlates and relationship to outcomes. Addictive behaviors. 2008;33(5):675-88.
  16. Rajati F sG, sadeghi M. . Comparison of three questionnaires on quality of life for heart Failure Patients in a cardic rehabilitation program. . Journal of Health system. 2012;10(1):25-97.