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Title: Practice-based evidence : cardiac care and doctor-patient communication
Author: Murray, Esther Louise
Awarding Body: City University, London
Current Institution: City, University of London
Date of Award: 2007
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Depression and anxiety are common in patients with coronary heart disease (CHD). As well as reducing health related quality of life, psychological problems can be a barrier to recovery and to making the necessary lifestyle changes to prevent worsening of cardiac health. A report on cardiac rehabilitation services in South East London (Marks & Filer, 2005) identified gaps in the services provided: not all CHD patients receive psychological support. Reviews of psycho-educational programmes in cardiac rehabilitation (Dusseldorp 1999 and Bennett & Carroll 1994) have found that group interventions can be effective in reducing emotional distress, targeting risk factors and increasing active coping. Cognitive behavioural techniques such as goal setting and evidence checking have been found to be effective when working with CHD patients (Lewin 2002). A psycho-education session based on cognitive behavioural techniques was designed and delivered to CHD patients as part of their usual Phase III cardiac rehabilitation programme in 3 hospitals in South East London. Two types of session were delivered: one individualised and interactive, the other generic and didactic in style. The format and content of the intervention is outlined in a manual and the same manual was used to deliver the session each time. All patients received a written handout summarising the session. Patients were randomly allocated to the control or intervention group. Outcomes were measured by HADS, Dartmouth COOP and a behavioural questionnaire before and after the session. Results showed high levels of patient satisfaction with the intervention in terms of usefulness and feeling comfortable and accepted in the group format. There was no significant difference in HADS scores over time, or between groups. This project is a case study for the complexities of carrying out research with limited resources in the setting of the NHS and highlights the role of practice-based evidence.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (D.Psych.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available