***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: A multicenter clinical trial was conducted to evaluate the effects on compliance of a group counseling program for cardiac patients and spouses . The sample comprised 58 couples in which one of the partners had documented atherosclerotic heart disease and was enrolled in an outpatient cardiac rehabilitation program . The experimental intervention involved a ten-week series of group sessions based on symbolic interactionist role theory . The research used a quasi-experimental , three-group , time-series design : Experimental group 1 consisted of 17 patients and their spouses who participated in group counseling ; experimental group 2 consisted of 22 patients and their spouses , but only the patients participated in the group series ; the control group consisted of 19 patients and their spouses who did not participate in the experimental program .  Data were collected at baseline , ten weeks , and six months on four cardiac risk factors : weight loss , blood pressure , exercise , and smoking . Repeated measures analysis of variance showed a significant difference ( P less than 0.01 ) in mean body fat among treatment groups , with experimental group 2 having the greatest decrease over time . Patients in both experimental groups demonstrated lowered blood pressure , with a significant decrease ( P less than 0.05 ) in systolic blood pressure . Again , the largest decrease was in experimental group 2 . Changes in weekly exercise level were not significantly different among groups , although the highest compliance was reported by experimental group 1 patients . Results support the efficacy of group counseling based on an interactionist role theory framework to increase compliance . The anticipated effect of spouse participation was not confirmed OBJECTIVES This study evaluated the effectiveness of cardiac counseling and rehabilitation programs led by a nurse counselor , compared with normal care on outcomes for myocardial infa rct ion ( MI ) patients and their partners . METHODS A r and omized controlled trial with follow-up to 1 year was conducted with 100 patients recruited within 72 hours of a first MI and their partners : a Control group received normal care ; an Inpatient group received cardiac rehabilitation from a nurse counselor while in hospital ; and an Extended group received the same cardiac rehabilitation as the Inpatient group , but with additional sessions continuing up to 6 weeks after discharge from hospital . The scales for main outcome measures were 1 ) knowledge of heart disease and treatment ( correct , misconceptions , and uncertainty ) ; 2 ) mood ( Hospital Anxiety and Depression Scale ) ; 3 ) satisfaction ; 4 ) disability ( Functional Limitations Profile ) . RESULTS Inpatient cardiac counseling and rehabilitation result ed in more knowledge , less anxiety , less depression , and greater satisfaction with care in both patients and partners and in less disability in patients , with effects enduring to 1 year . There was some evidence of additional benefit from the Extended program . Both nurse counselors achieved benefits on all outcome variables . CONCLUSIONS This Inpatient cardiac counseling and rehabilitation program result ed in significant and enduring benefits of clinical value . It is likely that it would be acceptable to most post-MI patients , many of whom are not offered or are unable to accept outpatient cardiac rehabilitation OBJECTIVE The purpose of this study was to determine the effectiveness of an information and support telephone intervention for reducing anxiety in patients who have undergone coronary artery bypass graft surgery and their partners . DESIGN The study is a r and omized controlled trial . Intervention began at discharge ; 6 telephone calls were made to patients and partners over 7 weeks . Primary outcome was Beck Anxiety Inventory measured at baseline in hospital , at home on day 3 , week 4 , and week 8 . SAMPLE The subjects were 131 patients who have undergone elective coronary artery bypass graft surgery and their partners . RESULTS Patients ' anxiety was moderate to severe the day before discharge . It was significantly lower in the treatment group than in the control group at day 2 at home . Partners always had lower anxiety than patients . A more sustained decrease in anxiety in the partner treatment group was found at both day 2 and week 4 . CONCLUSION Intervention effect is in the early period after discharge-- the time most affected by reduced lengths of stay The effects of a brief couple therapy intervention in cardiac rehabilitation was investigated in a r and omised controlled trial . The treating physician and a psychologist conducted an intervention of two to four sessions with 19 patients with coronary diseases at the IIa stage according to WHO and their partners . The 21 patients in the control group received st and ard care with no additional intervention .  Depressive symptoms , global self-rating of health status and disease related concerns were assessed at the beginning of training and nine months later . Patients in the experimental group more often stated to feel better immediately after the intervention . Over the observation period they showed significantly more favour-able changes in observer rated depressive symptoms , self-rated health status and concerns . Patients and partners in the experimental group assessed the outcome of rehabilitation significantly more positive after nine months . The findings suggest that a very short couple therapy intervention , which can be administered in routine care , can have positive effects in cardiac out-patient rehabilitation . Larger studies are required for testing whether the effects of such interventions are restricted to depressive symptoms and subjective appraisal s , or whether other outcome criteria such as mortality can also be influenced Self-ratings of anxiety and depression were studied over six months in 60 male patients , under 66 yr of age , who were admitted to a coronary care unit with a first time acute myocardial infa rct ion . Patients were r and omly assigned to either a treatment group , where they received a simple programme of in-hospital counselling in addition to routine care , or to a control group , where they received routine care only . All patients completed the Hospital Anxiety and Depression scale and a battery of visual analogue scales measuring anxiety on a range of topics related to recovery from a myocardial infa rct ion . Patients who received in-hospital counselling reported statistically significantly less anxiety and depression than those who received routine care alone . This effect was sustained for six months after leaving hospital . It is concluded that a simple programme of in-hospital counselling , provided by a coronary care nurse , is efficacious and should be routinely offered to first myocardial infa rct ion patients in hospital A r and omized trial using controls tested whether psycho-social rehabilitation of acute myocardial infa rct ion ( MI ) patients would improve significantly their return to work rate and assessed the importance of various psychological , social , occupational , socio-demographic , and medical factors in facilitating or impeding rapid return to work .  Eighty-nine patients were assigned r and omly to participate in an experimental cardiac rehabilitation program ( rehab care ) , and 91 patients were controls who received conventional hospital rehabilitation ( usual care ) .  By the first follow-up interview at three months , patients assigned to experimental treatment were significantly less distressed psychologically and less dependent on family support than controls ( P = 0.04 and P = 0.05 , respectively ) . By the final follow-up interview at 13 months , there was a marginally significant difference in favor of the experimental group in the frequency of reported deterrents to work resumption ( P = 0.07 ) . However , the intervention did not result in a statistically significant difference in the return to work rate ( P greater than 0.10 ) . In each group , 88 % were back at work by approximately the first year after infa rct ion . In addition , the two groups were similar in the amount of time patients remained out of the workforce ( median days rehab care = 75 , usual care = 81 ; P greater than 0.10 ) . A multi-stage data analysis procedure utilizing the Cox regression technique indicated that while several independent variables had significant univariate associations with the length of time patients convalesced , outcome was most influenced by the patient 's initial cardiological status and clinical course , by the patterns of family support , and by the several variables measuring the presence of obstacles to resuming work . Our findings suggest that rehabilitation programs intervening on multiple levels ( psychological , social , occupational , and physical ) may best meet the needs of chronically ill cardiac patients . Results indicate that implementing measures addressing the patient 's general psycho-social adjustment to MI may improve existing programs Self-ratings of satisfaction were studied over 6 months in 60 male first-time myocardial infa rct ion patients and their wives . Couples were r and omly assigned to either a treatment group , where they received a simple programme of education and psychological support in addition to routine care , or to a control group , where they received routine care only . All patients completed visual analogue scales measuring satisfaction regarding their general health , life in general , care and information received . All wives completed visual analogue scales measuring satisfaction regarding information received and care the patient received . Patients and wives in the treatment group reported statistically significantly more satisfaction than those in the control group . This effect was sustained for 6 months after counselling This study monitored and compared levels of anxiety and depression reported by first myocardial infa rct ion ( MI ) male patients and their partners , throughout the patients ' hospital stay . An independent variable of a programme of supportive-educative counselling provided by a coronary care nurse was introduced to determine whether it significantly affected reactions . Sixty couples were r and omly assigned to one of two groups : ( a ) the treatment group ( in which they received the systematic programme of nursing support in addition to routine care ) , or ( b ) the control group ( in which they received routine care but no other intervention ) . Anxiety and depression were measured by the Hospital Anxiety and Depression ( HAD ) scale at 24 hours and 5 days after the patient 's admission to hospital . At 5 days there were statistically significant differences between both groups with respect to the HAD scale mean scores . These findings strongly suggest that a simple programme of in-hospital couple counselling , provided by a coronary care nurse , statistically significantly reduces anxiety and depression in first MI male patients and anxiety in their partners This experimental study examined the effectiveness of a psychoeducational intervention delivered over 12 weeks . The sample was comprised of 38 coronary artery bypass graft ( CABG ) surgery patient-family member caregiver dyads who completed all six data collection points . Experimental and control groups did not differ in emotional health , functional health status , or satisfaction . Differences in the number of self-reported complications/symptoms were not in the predicted direction . Improvement occurred in clinical , functional , and emotional outcomes ; however , several symptoms , such as fatigue and pain , persisted . Family caregivers reported more depressive symptoms than patients preoperatively and at later stages of recovery . Implication s include the need for instruction about the recovery trajectory and adequate preparation and support of home health nurses and family caregivers Self-ratings of anxiety and depression were studied over six months in 60 wives of first time myocardial infa rct ion patients . Couples were r and omly assigned to either a treatment group , where they received a simple programme of education and psychological support in addition to routine care , or to a control group , where they received routine care only . All wives completed the Hospital Anxiety and Depression scale and a battery of visual analogue scales measuring anxiety on a range of topics related to recovery from a heart attack . Wives in the treatment group reported statistically significantly less anxiety than controls . This effect was sustained for six months after the counselling . It is concluded that a simple programme of in hospital counselling is efficacious and should be routinely offered to the wives of coronary patients 
    Output:
    
RESULTS Seven studies comprising 673 participants were included , two of which indicated that psychological interventions result in modest improvements in patients ' depressive symptoms , anxiety , knowledge of disease and treatment , and satisfaction with care , and in partners ' anxiety , knowledge and satisfaction .
There was no evidence of a significant effect on mortality , morbidity or cardiovascular risk factors for patients or social support for patients and partner .
As only two of the seven studies result ed in modest improvements in outcomes , no firm conclusions can be drawn as to the effectiveness of such interventions in this population