Rational Emotive Behavioral Therapy for Coronary Artery Disease Patients Undergoing Coronary Artery Bypass Grafting

The study was aimed at evaluating the effectiveness of rational emotive behavioral therapy (REBT) used to estimate personal perception of illness and coping strategies in coronary artery disease patients before and after coronary artery bypass grafting. 74 male patients aged from 44 to 73 underwent routine clinical examination and psychological assessment before and after coronary artery bypass grafting (CABG). All patients were enrolled either in Group 1, who received psychological supervision, or Group 2 without psychological supervision. Every patient underwent at least six psychological sessions; half of them were performed in the preoperative period and another half on days 8-10 after the indexed surgery. All patients underwent the standard examination on days 7-10 before CABG and on days 9-11 after CABG. Patients' perception of illness and coping behavior were evaluated using the Personal Questionnaire of the Bekhterevsky Institute, commonly referred as the TOBOL test. Coping behavior was assessed with the coping strategies. REBT was used to modify patients' perception and avoid the use of nonproductive coping behavior. The following REBT methods were used: rehabilitation goal setting diaries, cognitive restructuring, rehearsal of adaptive behavior, and Jacobson's relaxation technique. Patients who received psychological supervision demonstrated a positive trend towards using harmonious and ergopathic illness perception models, which are commonly included in the adaptive behavior pattern. Patients without psychological support reported a decrease in using the anxiety-related behavioral pattern, which included concerns and fears about the unfavorable outcome of the surgery. Patients under psychological supervision more frequently took the responsibility, both in terms of scores and the number of patients who started to use it. Importantly, patients less frequently switched to the maladaptive coping-strategies, namely confrontation and positive revaluation. Patients without psychological support less frequently accepted the responsibility. In addition, the number of patients who used self-control and searched for social support decreased. Importantly, patients in this group commonly switched to the escape-avoidance coping strategy after the indexed surgery. The obtained results suggest that REBT is beneficial in the formation of adaptive behavioral patterns and contributes to a wide use of productive coping strategies, thus improving illness perception model in patients with coronary artery disease referred to elective coronary artery bypass grafting.

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