Abstract
D.Litt. et Phil. (Psychology)
It is an accepted fact that the incidence of coronary heart
disease has reached endemic proportions in South Africa.
One of the fastest growing clinical populations in this
domain is that of the coronary artery bypass patient. As
a result the facilities catering to the biomedical needs of
this population are amongst the most sophisticated in the
world. However, facilities for the effective psychosocial
rehabilitation of these patients are relatively scarce.
When they are addressed they tend to focus essentially on
secondary emotional factors impeding reintegration back
into society. A sadly neglected psychosocial factor and
independent risk factor is that of the Type A behaviour
pattern. Extensive research in this area has not only found
this behaviour pattern to be detrimental to effective
rehabilitation but has also found it to be instrumental in
the reocclusion of grafted blood vessels resulting in an
elevated re-operation rate as well as putting these
patients at risk for a potentially fatal coronary event. In
an attempt to address this problem a rehabilitation group
intervention program adapted for South African conditions
was launched. This program was based on the Recurrent
Coronary Prone Prevention Project intended for the
treatment of post-myocardial infarct patients in San
Francisco. Essentially the aim of the project was to
ascertain whether this intervention could be applied
effectively to the coronary artery bypass population and
whether its duration could significantly shortened so as to
be more economically viable given the limited economic
resources characteristic of the health care services in
this country.
The modified programme was administered to a group of 13
post-coronary artery bypass graft patients at two local
cardiac rehabilitation centres. A second group of 10
patients at these same centres served as a no-treatment
waiting list control group, while simultaneously undergoing
an aerobic exercise and cardiovascular counselling
programme. Results of the study indicate the modified
programme to be highly successful in modifying Type A
behaviour and its components within the South African
context in the post coronary artery bypass patient samples
exposed to it. Comparisons of the experimental and control
groups after the intervention showed statistically
significant differences on the majority of measures. Thus
it was- concluded that the modified programme has the
potential to be an invaluable aid in the treatment of .this
population in South Africa. Presently, however, this sample
is being monitored longitudinally in order to ensure that
the treatment benefits remain.