Abstract
Ph.D.
It has become an accepted fact that Coronary Heart Disease is an epidemic of modern
civilisation. Coronary Heart Disease is responsible for approximately a third of all deaths
in the Western world (Fullard, 1990) and South Africa is no exception.
Several risk factors contributing to the development of heart disease have been identified
but the extent and exact nature of their contribution is not fully understood. Traditionally
accepted risk factors that play a role in the development of Coronary Heart Disease
include diet, hypertension, hypercholestrolaemia, smoking, physical inactivity, age, sex and
genetic disposition. However the strongest combination of these factors has been unable
to predict the majority of heart disease cases. In this regard psychological factors are
steadily gaining acceptance as risk factors, one of the most important of these being the
Type A behaviour pattern.
The far reaching consequences of Coronary Heart Disease have necessitated investigations
into methods of decreasing contact with risk factors, particularly psychological ones. The
substantial success of the Recurrent Coronary Prevention Project (Friedman et al),
coupled with the promising results from other intervention studies, suggests that
behaviour change is a viable goal in the prevention of heart disease.
Following on from the Recurrent Coronary Prevention Project, Venter (1993) and Viljoen
(1993) adapted it for the South African population. Although relatively successful, it did
have its flaws. Thus the motivation for redesigning this intervention addressing its
shortcomings
The revised intervention was administered to a group of 25 Coronary Heart Disease
patients. A second group of 22 patients were subjected to the intervention utilised in the
original South African Recurrent Coronary Prevention Project. A third group of 18
patients served as a waiting list control group. The results indicated that although the
revised intervention produced larger changes in Type A behaviour than the original South
African Recurrent Prevention Project intervention, these differences were not significant.
Possible reasons for this were the measures utilised, the sample sizes and the nature of the
groups themselves. However, the revised version of the SARCPP was found to be more
effective in the reduction of the hostility and anger components of the behaviour pattern
than the original version. In conclusion it was found that before any further research in
this area be conducted, the measures utilised should be modified and the mechanisms of
treatment effect be examined.