The effects of a PRECEDE-based educational program on depression, general health, and quality of life of coronary artery bypass grafting patients

Background: Depression is commonly reported as a consequence of coronary artery bypass grafting surgery. It is the most important barrier to proper treatment of cardiac patients, causing failure in accepting the condition, decreasing the motivation in following the therapeutic recommendations, and negatively affecting the patients' function and quality of life. Objective(s): The objective of this study was to investigate the effects of a PRECEDE-based educational program on depression, general health, and quality of life in coronary artery bypass grafting surgery patients. Methods: The experimental study included 54 post-bypass surgery patients in Isfahan Cardiovascular Research Center. The patients were randomly assigned to intervention and comparison groups (27 patients in each). The data were collected using four questionnaires (Cardiac Depression Scale, General Health Questionnaire-12, SF-36, and a PRCEDE-based questionnaire to measure predisposing, reinforcing, enabling factors, and self-help behaviors). All subjects were pre-tested. The intervention, consisting of nine educational sessions per week (60-90 min each) was implemented. The patients were followed for 2 months post-intervention and post-tested at the end of the second month. Results: Following the educational intervention, the mean scores of predisposing factors, enabling factors, reinforcing factors and self-helping behaviors were significantly increased in the intervention group, compared to the comparison group (p < 0.001). The mean score for depression in the comparison group (104.5 +/- 30.4) and intervention group (112.8 +/- 21.9) decreased significantly following educational intervention, but the change was more pronounced in the intervention group compared with the control group (66.2 +/- 22 vs. 89.2 +/- 27.8). The difference between the two groups on the basis of general health was statistically significant (p < 0.0001). Improvements in quality of life on the basis of physical function (p < 0.04), role limitations resulting from emotional status (p < 0.01), and mental health (p < 0.04) were statistically significant. Conclusion: The findings of the study confirmed the effectiveness of an educational program based on the PRECEDE Model on decreasing depression level, improving general health, and increasing quality of life in coronary artery bypass grafting surgery patients. (C) 2010 Elsevier B.V. All rights reserved.