Various psychosocial factors are important to the overall recovery of patients who suffer CHD events. Cardiac rehabilitation programs provide an opportunity for identification of patients having severe psychosocial problems. In this environment, these patients can be adequately screened, offered available programs, or referred for further long-term management. It remains unclear as to whether interventions in the cardiac rehabilitation setting improve psychosocial outcome. The use of groups for education and counseling as part of cardiac rehabilitation have been demonstrated to improve quality of life in a few well-designed randomized trials.82-84 These studies have produced only modest improvements in psychosocial functioning. Clearly (as with risk factor modification) additional well-controlled studies and confirmatory studies of those showing promising results are needed to prove the benefit of cardiac rehabilitation. In the past, general approaches to study in this area often have yielded vague results. More specific interventions targeting specific psychosocial outcomes are likely to lead to better results. Until such studies are conducted, rehabilitation professionals need to continue to adequately screen and refer patients when appropriate to improve psychosocial outcomes.
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