Interventions that improve health-related quality of life in patients with myocardial infarction
OBJECTIVE This study evaluated the effects of a home-based rehabilitation program for Chinese patients with myocardial infarction in terms of health-related quality of life and psychological status. METHODS This was a randomized, controlled trial with data collected at 2 university-affiliated public general hospitals in Xian (Shaanxi Province, People's Republic of China). One hundred and sixty patients with a myocardial infarction were randomly assigned to either the interventional group (a home-based cardiac rehabilitation program using a self-help manual) or the control group (usual care). Health-related quality of life (generic, Chinese Short Form 36-Item Health Survey; disease-specific, Chinese Myocardial Infarction Dimensional Assessment Scale) and psychological status (the Chinese Hospital Anxiety and Depression Scale) were measured at baseline, program completion (6 weeks), and 3 and 6 months after hospital discharge. RESULTS Significant differences were evident in the main outcomes when the home-based group was compared with the usual care group at 6 weeks, 3 months, and 6 months. The home-based group had significantly higher scores on 4 of the 8 domains of the Chinese Short Form 36-Item Health Survey and on 3 of the 7 dimensions of the Chinese Myocardial Infarction Dimensional Assessment Scale, with significantly lower scores on the anxiety, but not the depression, subscale of the Chinese Hospital Anxiety and Depression Scale. CONCLUSIONS A simple, home-based cardiac rehabilitation program for patients with acute myocardial infarction, using a self-help manual, improves health-related quality of life and reduces anxiety. It appears feasible and acceptable, and does not produce inferior outcomes compared with usualcare in China.