The effects of a rehabilitation program on the psychologic functioning of patients who experienced a myocardial infarction were studied. Patients were randomly allocated to either the Rotterdam outpatient cardiac rehabilitation program or to physician-encouraged home rehabilitation. Both groups (32 patients each) were tested three times over a period of six months with psychologic questionnaires that measured anxiety, stress, personal and social inadequacy, rigidity, dominance, self-esteem, and feelings of being disabled. The data show that the outpatient rehabilitation program leads to diminished sense of social inadequacy in the patient compared with home rehabilitation. Furthermore, feelings of anxiety and social inadequacy decreased in the patients in the outpatient rehabilitation group and feelings of self-esteem were enhanced. Three other important results were found: (1) the outpatient rehabilitation program had no demonstrable influence on work resumption; (2) it had a favorable effect on smoking habits since half of the smokers stopped smoking; and (3) participation in a cardiac rehabilitation program promoted habitual exercise. It is concluded that group cardiac rehabilitation on an outpatient basis is superior to physician-encouraged home rehabilitation.
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