Quality of Life Research, 2, pp. 121-127 Positive effects of increased nurse support for male patients after acute myocardial infarction A.-L. Unden,* K. Schenck-Gustafsson, P.-O. Axelsson, I. Karlsson, K. Orth-Gom& and A.-M. Ydrefors Department of Cardiology, Karolinska Hospital (K. Schenck-Gustafsson, P.-O. Axelsson, I. Karlsson, A.-M. Ydrefors), National Institute for Psychosocial Factors and Health, Karolinska Institute Box 60210 S-10401 Stockholm, Sweden (A.-L. Und& K. Orth-Gom&) The effect of increased nurse support on patients below 70 years of age attending an out-patient clinic following acute myocardial fnfarction was evaluated. Patients who saw a nurse 14 days after discharge (n = 56) were compared to a control group (n = 47) who, following the ordinary routines, were first seen 6 weeks after discharge. Increased nurse support had positive effects on psychosocial variables such as depressive feelings, expected quality of life in the future, and satisfaction with contact with the staff. However, no effects were found on any of the cardiac variables. Patients in the intervention group showed a decrease in depressive feelings during the 6 weeks follow-up period, whereas there was an increase for the control group. The patients in the intervention group also tended to have a better belief in the future compared to the control group. Patients in the intervention group were more satisfied with the staff contact than were the control group. Introduction Acute myocardial infarction (AMI) disrupts many aspects of life, including a person’s ability to be physically active, perform social roles, and persue daily activities with vigour and enthusiasm.’ Pati- ents who suffer AM1 often express anger about the physical and psychosocial discomfort and feel insecure about the future: depression of mood commonly follows AMI. * The patient thus needs a lot of support and understanding throughout the illness and convalescence to enable him to handle these feelings. For many patients psychological, psychosocial, and emotional difficulties constitute the major barrier to recovery. Good aftercare with respect to these issues is, therefore important in the rehabilitation and recovery to health and a l To whom correspondence should be addressed 0 1993 Rapid Communications of Oxford Ltd good quality of life of patients after AMI. Data are now available that suggest the ability of psychoso- cial and biobehavioural variables to predict clinical events independent of the severity of disease.3-6 With this as a background, a study was designed to evaluate the effect of increased nurse support for AM1 patients in an outpatient clinic, and relate this to different aspects of rehabilitation, cardio- logical as well as psychosocial and psychological. Material and methods Study group The study was a randomized study involving male patients below the age of 70 years who were admitted to our CCU due to AMI during the 2 year period December 1987 to April 1989. As the patients had to fill in complicated questionnaires, those who were senile and those who did not understand the Swedish language were excluded. The 103 patients who were included were ran- domly assigned to one of two groups: an interven- tion group (with increased nurse support) and a control group (following the ordinary routines). The increased support implied that the patients got an extra next visit at the outpatient clinic 14 days after discharge instead of waiting 8 weeks which is the ordinary routine. One day prior to discharge, the patient got a sealed envelope with information on the group assigned and a question- naire. The nurses were not aware of to which group the patients belonged. The patients who were not willing to participate comprised 18% usually because they lived far from the hospital catchment area. The study group comprised in all 103 male Quality of Life Research . Vol2 .1993 121