Psychosocial outcome assessments for use in cardiac rehabilitation serviceevaluation: a 10-year systematic review

A variety of measures are currently used to assess psychosocial outcome (qu ality of life) in cardiac rehabilitation programmes. However, there is no c onsensus on the most appropriate instruments to use. Instruments that are n ot sufficiently responsive to change in cardiac populations are unsuitable as audit tools as they underrepresent the benefits of programme attendance. To identify the most responsive instruments in cardiac rehabilitation popu lations a systematic overview of studies for the 10-year period 1986-1995 w as conducted. The following databases were searched: Medline, Psychlit, Cin ahl and Sociofile and 32 relevant studies were identified. The effect size statistic (a comparison of the magnitude of change to the variability in ba seline scores) was used to determine those instruments most responsive to c hange. The following instruments were identified as being responsive in mor e than one study: Beck Depression Inventory, Global Mood Scale, Health Comp laints Checklist, Heart Patients Psychological Questionnaire and Speilberge r State Anxiety Inventory. There is little consensus on psychosocial evalua tion instrument use in the cardiac rehabilitation literature. A number of m easures show significant potential for routine outcome assessment. Formal a ssessment of these instruments is recommended to inform final recommendatio ns about instrument selection for audit and evaluation purposes in cardiac rehabilitation. (C) 1999 Elsevier Science Ltd. All rights reserved.