Abstract 16389: Beyond Depression: Benefits of Cognitive Behavioral Therapy in Cardiac Surgery Patients
Introduction: Depression after cardiac surgery (CS) is associated with increased pain and decreased sleep quality. We have shown that nurse-delivered cognitive behavioral therapy (CBT) for depression is effective, but the effect of depression-focused CBT on other post-CS outcomes is unknown. The purpose of this study was to determine if CBT for depression influenced postoperative pain, sleep, perceived control, and social support.
Methods: After screening positive for clinical depression, 53 post-CS patients (mean age = 64 ± 10 years, 83% male, 28% single) were randomized to usual care (UC) or 8 weeks of CBT by trained nurses. At baseline and post-intervention, patients completed questionnaires for depressive symptoms (Beck Depression Inventory), pain (Brief Pain Inventory), sleep (Pittsburgh Sleep Quality Index), perceived control (Cardiac Attitude Scale-Revised) and social support (Perceived Social Support Scale). Change over time was evaluated by repeated ANOVA controlling for baseline values. Patient characteristics likely to influence CBT outcomes were evaluated by linear regression.
Results: Compared to UC, the CBT group showed greater increase in perceived control and reduction in pain interference (Figure), with a trend toward improvement in social support (time x group interaction , p = .11). Improved perceived control was significantly associated with younger age (Std Beta [SB] = -.28, p = .04) and improved sleep quality (SB = -.52, p <.01) and social support (SB = .51, p <.01). Decreased pain interference was significantly associated with younger age (SB = .33, p =.01), lower baseline depressive symptoms (p = .29, p = .01), and decreased pain severity (SB = .71, p < .01).
Conclusions: This study demonstrates that a depression-focused CBT intervention yields benefits in other common postoperative problems. Future studies should investigate the potential of CBT as a broad therapeutic tool in this high risk population.
Author Disclosures: L. Doering: None. B. Chen: None. J. Eastwood: None. A. McGuire: None. R. Cross-Bodán: None. M. Irwin: None.
- © 2014 by American Heart Association, Inc.