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European Journal of Physical and Rehabilitation Medicine 2020 Jan 23

DOI: 10.23736/S1973-9087.20.05970-5

Copyright © 2020 EDIZIONI MINERVA MEDICA

lingua: Inglese

Psychophysical health of great elder inpatients in cardiac rehabilitation: a retrospective cohort study

Gianluigi BALESTRONI 1, Anna PANZERI 1 , Pierangela OMARINI 1, Paola CERUTTI 1, Daniela SACCO 1, Andrea GIORDANO 2, Massimo PISTONO 3, Klara KOMICI 4, Silvia ROSSI FERRARIO 1

1 Psychology and Neuropsychology Unit of Veruno Institute, Istituti Clinici Scientifici Maugeri IRCCS, Veruno, Novara, Italy; 2 Bioengineering Unit of Veruno Institute, Istituti Clinici Scientifici Maugeri IRCCS, Veruno, Novara, Italy; 3 Cardiology Department of Veruno Institute, Istituti Clinici Scientifici Maugeri IRCCS, Veruno, Novara, Italy; 4 Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy


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BACKGROUND: Elderlies in cardiac rehabilitation show a particular frailty due to specific aging issues, thus specific professional psychophysical care is required.
AIM: This study aimed at evaluating the effect of a cardiac rehabilitation program enhanced with psychological support on the psychophysical health of ≥75elderlies. Moreover, the association of psychophysical conditions with the long-term post-discharge course of medical events was examined.
DESIGN: This retrospective cohort study was conducted on ≥75elderly patients admitted from 2015 to 2019 to a cardiac rehabilitation program including psychological support.
SETTING: The cardiac ward and the psychology unit of a post-acute clinical rehabilitation Institute.
POPULATION: A total of 523 elderly inpatients (females=44%), aged ≥75 years (mean=79.7±3.46), admitted to a cardiac rehabilitation ward due to heart disease.
METHODS: Psychological and functional variables such as depression, quality of life, and Barthel Index were measured at hospitalization and at discharge. The medical events after discharge such as emergency department accesses and rehospitalizations were registered.
RESULTS: Cardiac rehabilitation showed significant improvements both in elderlies’ psychological and physical health. Higher depression levels predicted a worse post-discharge course. Patients who received psychological intervention accessed emergency department and were re-hospitalized significantly later than the others.
CONCLUSIONS AND IMPLICATIONS: Cardiac comprehensive rehabilitation can significantly improve the psycho-physical health of ≥75 elderlies who benefit of psychological support. Psychological support can enhance the psychophysical health of great elder inpatients in cardiac rehabilitation.
CLINICAL REHABILITATION IMPACT: Given the associations with short and long-term outcomes, health professionals should take care of the psychological conditions of elderlies (e.g., depression) by elderlies’ psycho-physical conditions, quality of life, as well as more favorable medical outcomes.


KEY WORDS: Great elders; Cardiac rehabilitation; Psychophysical health; Psychological intervention

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