Katie Cosby
PSYCH 3460
Extra Credit: Gullicksson, Orth-Gomer, Linden
Gullicksson et al. 2011:
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Conceptual independent variable: psychosocial factors

Conceptual dependent variable: risk of CVD
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Operational independent variable: CBT program

Operational dependent variable: hospital admission for recurrent CVD
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SCV: The intervention group had a 41% lower rate of fatal and nonfatal first
recurrent CVD events and an insignificant 28% lower all-cause mortality.

IV: Because there was significant evidence that the CBT program decreased
risk of recurrent CVD, it is plausible to claim that psychosocial factors
increase the risk of CVD.

CV: A threat to construct validity in this study is the fact that the CBT
program solely focuses on stress, which excludes several other psychosocial
factors (issue of operationalization).

EV: 362 is a significant and meaningful sample size and the median
attendance of 85% is also fairly significant. Furthermore, “75 years or
younger” is a large population size and allows for a wider generalization of
the findings.
Orth-Gomer et al., 2009:

Conceptual Independent Variable: Psychosocial stress

Conceptual Dependent Variable: Prognosis of CHD in women

Operational Independent Variable: Stress Reduction Program

Operational Dependent Variable: Mortality Rate

SCV: Women in normal care had a mortality rate of 20% while women who
also received psychosocial intervention had a mortality rate of 7%. Because
of this significant decrease in mortality rate, the variables appear to be
statistically related.

IV: Because there was a significant decrease in mortality rate among women
who received psychosocial intervention, it is plausible to suggest that
psychosocial stress increases the risk and severity of CHD in women.

CV: Psychosocial stress is proven to be managed through stress reduction
programs, so I do believe this operationalization reflects the initial variable.
The prognosis of CHD however, is not always reflected in mortality, so I
believe the operationalization of the dependent variable could’ve been
improved.

EV: 237 is a meaningful sample size, so the findings could be generalized to
other populations. However, these findings are most likely only reflective of
the female population due to the sample being entirely composed of women.
A. Patients hospitalized for CHD

Patients will be admitted to the program based on their age (under 70),
severity of condition (below emergent), and comorbidities (2 or less).

The program will require attendance to educational classes once every other
week. These classes will provide information on relaxation techniques, stress
management, and self-monitoring techniques.

Also, once a month, the patient will receive one-on-one training that centers
on implementing the practical aspects of the educational classes.

In the instance that a patient has to undergo surgery or is subject to an
invasive test, their one-on-one “mentor” will be present before and after the
procedure to aid in lessening negative psychosocial factors.
B. Patients continuing on to cardiac rehabilitation

Patients will be admitted with the pretext of certain absence/presence of
habits: no smoking habits, minimal alcohol consumption, moderately to
extremely healthy diet, at least one hour of exercise per week, etc.

The program will require attendance to educational classes once per month
and attendance to small-focus groups once per month. The educational
classes will allow attendance for 100 people and focus groups derived from
this large group will consist of 5 people each.

The large class will center on relaxation techniques, stress management, and
self-monitoring techniques. The focus groups will be largely self-governing
and will decide independently which topics are relevant to discuss in further
detail.
Program Prospectus:
The program proposed for patients hospitalized for CHD focuses on
addressing psychosocial issues that may worsen CHD. Many studies have shown
significant decreases in mortality rates amongst patients who undergo psychosocial
programs in addition to normal care. The classes that the patient will be required to
attend are occasional and brief – making them very low maintenance and easily
manageable for the patient. In addition to these classes, the patient will receive oneon-one training for a more personalized experience. Also, providing a “mentor” for
the patient during especially stressful situations such as pre-surgery prep, will
lessen complications that could derive from heightened stress and anxiety.
The program proposed for patients who are continuing on to cardiac
rehabilitation are also manageable for individuals because they are brief and
occasional. Also because there are certain requirements for being admitted to the
program, the patient will be encourage to discontinue unhealthy practices in order
to receive the psychosocial assistance. The patient will receive overarching
knowledge through large classes and more individual-based knowledge and
information through small, focus groups.
Because of the proven positive affects that psychosocial programs have on
the severity, recurrence, and mortality rates of CHD, this program should be
included in a patient’s coverage. This program has the potential to reduce further
medical complications and expenditure, therefore acting as a preventative measure
that is significantly beneficial in the long-term consideration of the patient’s care
and financial burden.