Daily Stress and Social Support among Women with CAD: Results from a 1-year Randomized Controlled Stress Management Intervention Study
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Psychosocial stress may play a causative role in development and progression of coronary artery disease (CAD).
We investigated the effects of a 1-year stress management program on daily stress behavior and social support among female CAD patients.
Women, 247 (≤75 years), hospitalized for a cardiac event were randomized to either a control or an intervention group. Controls obtained usual health care; intervention patients participated in 20 2-h group sessions of stress management therapy and obtained health care by a cardiologist. Measurements were at baseline, 10 weeks (after ten sessions), 1-year (end of intervention), and at a 1- to 2-year follow-up.
Daily stress scores for the intervention and control groups were at baseline 39.5 ± 8.1 vs. 37.2 ± 9.1 (p = 0.06), 10 weeks 37.2 ± 8.0 vs. 35.5 ± 9.4 (p = 0.20), 1-year 36.1 ± 7.2 vs. 35.9 ± 8.5 (p = 0.85), and at 1–2 year follow-up 34.0 ± 7.8 vs. 35.3 ± 8.7 (p = 0.32), respectively. Intention to treat analyses showed interaction between treatment and time [F(3,213) = 2.72; p = 0.01] reflecting that the decrease was more pronounced in the intervention group. There was no evidence for a difference in change concerning social support.
CAD women in the intervention group had a more pronounced reduction of self-rated daily stress behavior over time compared to controls. However, as the intervention group had higher baseline values, due to regression toward the mean, we have no evidence that the difference in decrease of daily stress was due to the intervention.
KeywordsStress management intervention Social support CAD Women
We thank Gunilla Burell, PhD, for sharing her experiences in performing and developing stress management programs for men and women with CAD. Special thanks also to research nurses: Gun Wesley, Diana Karlsson, Gunilla Gabriel, Gunilla Levin, Åsa Hemberg, Birgitta Welin at Karolinska University Hospital, Huddinge and Charlotta Cronsten-Engberg, Anna Johannesen, Christina Walldin at St Görans Hospital for very skillful assistance.
We also thank cardiologists Jan-Olof Magnusson MD, PhD, Staffan Hederoth, MD, Barbro Kedinge Cyrus, MD, and Gunilla Wennersten, MD, who were responsible for the treatment of patients in the intervention group at St Görans Hospital.
This study was supported by grants from the Ansgarius Foundation, the Belven Foundation, the Swedish Heart and Lung Foundation, the Public Health Committee, as well as EXPO-95 of Stockholm County Council, the Swedish Medical Research Council (project 19X-11629), the Vardal Foundation, all in Stockholm, Sweden.
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