Abstract
D.Litt. et Phil. (Psychology)
It has long been known that South Africans are a high risk
population for the development of coronary heart disease.
Cardiovascular diseases accounted for 8,7% of all deaths in
this country in 1988. Despite this distressing situation,
rehabilitation facilities for people who have suffered a
myocardial infarction or heart attack are relatively
scarce. The facilities that exist tend to focus on the
biomedical aspects of cardiac rehabilitation such as
exercise and diet, and tend to neglect the psychosocial
factors. A review of the literature shows, however, that
psychosocial factors, and in particular the Type A
coronary-prone behaviour pattern are significantly related
not only to the development of coronary heart disease, but
also to the probability of sUffering and surviving a heart
attack. In addition, Type A.behaviour has been shown to be
predictive of the risk of a second infarction after an
initial attack. For this reason, the proven technology of
a treatment programme developed under the auspices of the
Recurrent Coronary Prevention Project (Powell & Thoresen,
1986) was applied in an attempt to adapt the programme for
the" South African context. The study was aimed at
establishing whether the RCPP programme could successfully
be employed in this country, and whether the duration could
be shortened so as to be more economically viable given the
limited economic resources that characterise health care in
South Africa.
The modified programme was administered to a group of 13
post-myocardial patients at a local cardiac rehabilitation
centre. A second group of 11 patients at the same centre
served as a no-treatment waiting list control group, but
simultaneously underwent an aerobic exercise and
cardiovascular counselling programme. Results of the study
indicate that 'the modified programme is highly successful
in modifying Type A behaviour and its components in South
African sUbjects. Comparisons of the experimental and
control groups after the intervention showed statistically
significant differences on the majority of measures. It was
therefore concluded that the modified programme can be used
fruitfully in the local context, but it was cautioned that
the present sample needs to be followed up over time to
ensure that the treatment gains are maintained.