Effectiveness of Stress Inoculation Training on Heart Rate Variability, Salivary Cortisol, Anxiety, Stress, and Depression after Coronary Artery Bypass Graft Surgery

 This study aims to evaluate the effect of Stress Inoculation Training (SIT) on Heart Rate Variability (HRV), salivary cortisol and psychological complications (anxiety, stress and depression) after Coronary Artery Bypass Graft (CABG) surgery.

This is a quasi-experimental study with a pretest/posttest/follow-up phase. The study population consists of all patients who had underwent CABG surgery and referred to the Cardiac Rehab center of Tehran Heart Hospital in Iran. Of these, 30 patients were selected using a random sampling method and divided into two intervention and control groups. The instruments were a cortisol salvia ELISA kit, a HRV monitor, and the 21-item Depression, Anxiety and Stress Scale. The intervention group received SIT at 10 sessions of 90 minutes.

The results of multivariate analysis of covariance showed a significant difference in depression (P<0.001), anxiety (P<0.001), stress (P<0.001), salivary cortisol level (P<0.001) and HRV (P<0.001) between the two groups. The mean HRV was significantly higher in the intervention group than in the control group. In other variables, the mean scores were lower in the intervention group than in the control group.

Reduced negative emotions following SIT plays an important role in preventing the severe complications of heart disease. Interventions based on the SIT method are recommended for patients with heart disease.