Cardiac rehabilitation : guidelines & audit proformas / edited by David Thompson ... [et al.].

On title page : Royal College of Physicians of London, Royal College of Nursing, British Cardiac Society, British Heart Foundation.

Includes bibliographical references.

Overview:- Statutory/non-statutory fitness standards--Recovery and rehabilitation--The heart and heart work--Coronary heart disease and the transportation industries--Aviation--Sea--The lifeboat service--Diving--Railways--The fire service--Recreational aspects of cardiovascular disease--Conclusion--References--Recommended reading--PART 2: Return to Work:- Why should vocational issues be considered important?--What is the incidence of return to work and what factors are important in determining this?--Myocardial infarction--Coronary artery bypass surgery--Percutaneous transluminal coronary angioplasty--Cardiac transplantation--Who needs vocational rehabilitation?--What should be the goals of vocational rehabilitation?--How could resources be used to provide vocational rehabilitation?--General practitioners--Hospital teams--The cardiac rehabilitation programme--Specialised work evaluation--How should vocational issues be assessed?--The timing of assessment--The nature of assessment--How should vocational guidance be offered?--General guidelines for different risk categories--Physical risk factors--Psychological risk factors--Guidance for those unable to return to work--Reducing duration of absence from work--Summary--Summary of recommendations--References--Appendix 1--Appendix 2--7. The Economic component:- Economic evaluation--Cost analysis--Cost-effectiveness--Cost utility--Cost studies--Costs of rehabilitation--Effect of cardiac rehabilitation on hospitalisation costs--Return to work--Cost-effectiveness studies--Cost-utility studies--Summary--References--8. Guidelines and audit standards:- The rehabilitation process--The scope of caridac rehabilitation--The components of cardiac rehabilitation--Medical diagnosis and intervention--Psychosocial care--Exercise--Education--Vocational assessment--The cost-effectiveness of cardiac rehabilitation--The setting of cardiac rehabilitation--Responsibility for its provision--Clinical standards--Medical care--Psychosocial care --Exercise--Education--Contracting for cardiac rehabilitation--References--Appendix--Audit proformas.

1. overview:- Historical conditions-- Future prospects--Summary--References--2. The Medical component:- Medical goals of cardiac rehabilitation--Risk stratification--Further diagnostic testing and intervention--Therapeutics and risk factor modification--Programme management, efficacy and logistics--Conclusions--References--Appendix--3. The Psychological component:- The psychologicl goals--The psychological sequelae of coronary heart disease--Adjustment to myocardial infarction or diagnosis of coronary heart disease--Transplant patients--The course of adjustment in hospital--The course of adjustment following discharge--Long-term psychological outcomes--Improved quality of life--Continuing psychological illness--Reduced quality of life--Common problems reducing quality of life in patients with coronary heart disease--Perception of health--Activity--Return to work--Relationships--Sexual Activity--Anxiety and depression in partners--The main predictors of rehabilitation outcome--The integration of cardiac rehabilitation with routine medical care--The hospital phase--Counselling--Dealing with denial--Exercise--Relaxation training--Helpline--Post-discharge--Early convalescence--Rehabilitation programme--Psychological factors in exercise training--Counselling--Relaxation--Stress management training--Secondary prevention--Cognitive behavioural treatment for lifestyle changes--The role of the psychologist or liaison psychiatrist--Psychological assessment--Psychological distress--Cognitive dysfunction--Other outcomes--References--4. The Social Component:- The problem area approach to rehabilitation--Return to work--Relationships in the family: the role of the spouse/partner--Relationships with friends and confidants--Examination of assumptions behind the problem-centred approach--Gender differences--The social significance of ageing--Heterogeneity of patients--The social component reassessed--What can be done about \'social\' rehabilitation?--References--5. The Exercise component:- Physiological and metabolic adaptations to endurance (aerobic) training--Secondary prevention of coronary heart disease events--Mechanisms--Outcome measures--Influence on risk factors--Lipoproteins--Insulin/glucose dynamics--Blood pressure--Effects of each exercise bout--The exercise programme--Frequency of exercise--Intensity of exercise--Duration of exercise--Need for strength training?--Phases of exercise rehabilitation--Low-risk patients--High-risk patients--Supervised or unsupervised programmes?--Safety--Who should receive cardiac rehabilitation? Special needs--Summary--References--Appenix--6. The Vocational component:- Part 1: An