| BackgroundAt present, our country has entered the aging society. As pepole live longer, the survival rate of myocardial infarction and gradually improve due to the continuous improvement of cardiac interventional technique,Thus the propotion of coronary heart disease patients with heart failure are gradually increasing,Coronary heart disease has become the leading cause of heart failure in our country population.A large number of studies confirm exercise rehabilitation is safe for patients with heart failure,And it can improve exercise tolerance in patients with heart failure through rehabilitation exercise, it can improve the quality of life, and reduce the mortality and the incidence of cardiac events.Influenced by traditional ideas, the patients with heart failure exaggerated the risk of cardiac motion rehabilitation.their excessive worry and anxiety resuled in poor compliance. The compliance is related to the quality of exercise rehabilitation.Research shows, higher rates in elderly patients with coronary heart disease accompanied with anxiety, depressive disorder (24-42%).These negative emotions in turn have negative effects on patients with heart failure, forming a vicious spiral.Another study showed that, the activation of neuroendocrine system is the main formation mechanism of coronary heart disease, While the adverse psychological factors and type A behavior response mode often plays a trigger action.The above evidence suggests that, in elderly patients with coronary heart disease associated with a high proportion of negative emotion. It must have a negative impact on the prognosis of the disease and the next rehabilitation therapy.Through this study, to understand the implementation of psychological status before and after exercise rehabilitation treatment for coronary artery disease in patients with heart failure, and according to the given psychological intervention, to improve adherence to treatment, to explore the effective methods to improve the quality of life in patients with coronary heart disease and heart failure.ObjectiveTo investigate the psychological status in elderly patients with coronary heart failure disease in rehabilitation therapy and psychological intervention.Methodsthe82hospitalized elderly patients with coronary heart disease were randomly divided into two groups (intervention group and control group). Two groups received drug therapy for heart failure and rehabilitation exercise training under the guidance of rehabilitation therapist. The intervention group also received psychological treatments. HAMD and HAM A scores were evaluated. Blood pressure, heart rate, blood glucose and lipid profiles, ECG, heart color Doppler,6minutes walking distance, cardiac function (NYHA grade) were monitored at the baseline,4weeks and6months after treatments, respectively.ResultsThere were53depression cases (64.6%) and36anxiety cases (43.9%) in the two groups. There was no significant difference regarding HAMD score and HAMA score between the two groups at the baseline. However, after4weeks and6months treatments, the HAMD score of the intervention group were16.48±5.46and6.36±2.98, respectively, which were significantly lower than the control group (20.3±6.41,11.28±3.23, P<0.05).6minutes walking distance in the intervention group were significantly longer than that of the control group after4weeks treatment. Blood pressure, heart rate, lipid profiles,6minutes walking distance and cardiac function were improved markedly in the intervention group than the control group after6months treatment. Conclusion1.In elderly patients with coronary heart disease with a high proportion of negative emotion, mainly for depression, followed by anxiety.2.Exercise rehabilitation can effectively improve the elderly coronary heart disease patients with negative emotion, can effectively improve the cardiac function.3.Psychological intervention can effectively improve the compliance of exercise rehabilitation in elderly patients with coronary heart disease. |
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