V. Lynggaard; A. D. Zwisler; R. S. Taylor; O. May; J. Mortensen; C. V. Nielsen
Abstract
The objectives were to assess the short- and long-term effect of the patient education strategy ‘Learning and Coping’ (LC) incardiac rehabilitation (CR) on health-related quality of life, patient education impact, cardiac risk factors and lifestyle. In total,825 patients hospitalized with ischaemic heart disease or heart failure were randomized to either LC-CR or standard CR atthree Danish hospitals. Teaching approach in LC-CR was situational, inductive and reflective, with experienced patients as co-educators and supplemental interviews. Teaching approach in standard CR was structured and deductive. Outcomes wereassessed immediately after CR, and after 3 months (short term), and after 3 years (long term). Between-arm differences infavour of LC-CR were SF-12 ‘role emotional’ (3.7, 95% CI: 0.6–6.8) and MDI depression score (0.9, 0.1–1.8) immediatelyafter CR, exercise capacity (4 W, 1–9) at 3 months and SF-12 ‘role physical’ (4.6, 0.1–9.0) (long term). Between-armdifferences in favour of controls were waist circumference (-1.7?cm, -2.3 to -1.0) immediately after CR and HeiQ domain‘Constructive attitudes and approaches’ (0.11, 0.04–0.18), triglycerides (-0.12?mmol/l, -0.21 to -0.02), systolic bloodpressure (-3.12?mmHg, -5.66 to -0.58) at 3 months. Adding LC strategies to CR provides inconsistent short-term results butimproves ‘role physical’ long term.