An evaluation of two behavioral rehabilitation programs in improving the quality of life in myocardial infarct patients in Hong Kong

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An evaluation of two behavioral rehabilitation programs in improving the quality of life in myocardial infarct patients in Hong Kong


Author: Hui, Ngor
Title: An evaluation of two behavioral rehabilitation programs in improving the quality of life in myocardial infarct patients in Hong Kong
Degree: M.Sc.
Year: 2003
Subject: Hong Kong Polytechnic University -- Dissertations
Myocardial infarction -- Patients -- China -- Hong Kong -- Rehabilitation
Quality of life -- China -- Hong Kong -- Evaluation
Department: Multi-disciplinary Studies
School of Nursing
Pages: x, 139 leaves : ill. ; 30 cm
Language: English
InnoPac Record:
Abstract: Acute Myocardial Infarction (MI) is one of the major diseases reported to be increasing in Hong Kong (Lam et al., 1999). Rehabilitation becomes a main focus after cardiac patients were discharged from the hospitals and entered into the Outpatient Department (OPD) services. Thus, attention is strongly focused to formulate a well-structured and practical cardiac rehabilitation program in order to empower these patients' ability, prevention of relapse and maintain a good quality of life (QOL) after discharge from the hospitals. QOL is one of the important parameter being seriously considered in recent clinical studies. This is especially true for patients with heart diseases and as in other groups of chronic disease patients. Literature reviews on MI patients showed that many of the MI patients were persistently presented with anxiety, depression and different degrees of emotional problems and if not attended, these problems could be worse. Although there were studies being conducted on the QOL for MI patients, the majority of these studies were focused on a single dimension such as physical status of MI patients (Packa, 1989) and the CR1 services provided were mainly physical training, educational program or occasionally a psychological intervention; with most of these programs being single-modality oriented instead of utilizing disciplinary training. Practical training on conservation of energy and how to apply these skills in daily activities, work simplification skills for proper functional performance, different methods of relaxation techniques or self-regulatory exercises which can enhance the well-being of the individual should therefore be considered. These training are not replacing traditional medical treatments but can act as adjunct rehabilitation care for the MI patients to enhance their QOL. Skills to improve self-regulation of the body and the mind, such as relaxation trainings; and Qigong, which is a culturally familiar self-regulating health exercise, have shown benefits in previous studies in the rehabilitation for cardiac disease. As these exercises have shown some positive results for cardiac patients in previous studies, they can be further explored in order to find out if they can benefit the MI patients in CRP in the Hong Kong setting. The purpose of the present study is to evaluate two behavioural rehabilitation programs in improving the quality of life in myocardial infarct patients in the Hong Kong setting, namely a behavioural rehabilitation program which includes energy conservation, practical skill training in dealing with daily living task and particularly practical training in Progressive Relaxation, and a behavioural rehabilitation program which includes energy conservation, daily living task training in dealing with daily task and particularly the learning of Qigong exercise. A total of 59 subjects, 44 ma1es and 15 females were randomly assigned to one of the following rehabilitation program groups: Training in Daily Tasks and Progressive Relaxation group and Training in Daily Tasks and Qigong group. Physiological measures, including systolic (SBP); diastolic blood pressure (DBP); and heart rate (HR), were measured by a Dinamap blood pressure monitor. Psychological measures including the Chinese version of State-Trait Anxiety Inventory (STAI), the Chinese version of General Health Questionnaire (GHQ-12), and the Chinese version of Short-Form 36(SF-36). The SF-36 measures the quality of life (QOL) which includes eight domains: physical functioning (PF), limitations due to physical health problems (RP), bodily pain (BP), general health (GH), vitality (VT), social functioning (SF), limitations due to emotional health problems (RE), and mental health (MH). In addition, a demographic sheet was used to record the information on sex, age, diagnosis, marital status, educational level etc. of the subjects. Pre- and post-assessments were conducted in the two groups. 8 training sessions were conducted for each individual group for each rehabilitation program condition. Independent t-test was used to test for any significant difference in all dependent variables between the Progressive Relaxation (R) and Qigong (Q) groups at the pre-treatment and post-treatment occasions. Paired t-test was used to test for any significant difference at the pre-treatment versus post-treatment occasion of all dependent variables for the two groups. Results revealed that SBP and DBP were significantly reduced by using Progressive Relaxation in comparison with Qigong group at the post-treatment occasion. On the other band, SF-36 (RE) was significantly improved by practicing Qigong exercise in comparison with Progressive Relaxation group at the post-treatment occasion. At the pre-post treatment occasion, the results revealed that there were significant reduction in State-Trait Anxiety level, improvement m General Health Questionnaire and in Mental Health (MH) in SF-36 for subjects practiced Progressive Relaxation. In Qigong group, the results showed that there were significant reductions in Systolic Blood Pressure, State-Trait Anxiety level and improvements in General Health Questionnaire, Physical Function (PF), Role Physical (RP), General Health (GH), Vitality (V), Social Function (SF), Role Emotion (RE) and Mental Health (MH) in SF-36. These variables showed improvements in Qigong group at the pre-post treatment occasion. The findings in the present study support the previous studies that Progressive Relaxation and Qigong exercise could be effective interventions in enhancing the quality of life in myocardial infarct patients. The findings support previous studies that Progressive Relaxation, being a muscular-oriented relaxation method, is more effective in reducing somatic problems such as blood pressure and heart rate. And Qigong, being a self-regulating body-mind exercise, can benefit both of these dimensions. Apart from the therapeutic potentials as reported in the present findings, these exercises can be practiced by patients at home after suitable training, which hopefully can empower the ability of the patients towards their rehabilitation process.

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