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A cost efficiency application of the South African recurrent coronary prevention project.

Ph.D. / It has become an accepted fact that Coronary Heart Disease is an epidemic of modern civilisation. Coronary Heart Disease is responsible for approximately a third of all deaths in the Western world (Fullard, 1990) and South Africa is no exception. Several risk factors contributing to the development of heart disease have been identified but the extent and exact nature of their contribution is not fully understood. Traditionally accepted risk factors that play a role in the development of Coronary Heart Disease include diet, hypertension, hypercholestrolaemia, smoking, physical inactivity, age, sex and genetic disposition. However the strongest combination of these factors has been unable to predict the majority of heart disease cases. In this regard psychological factors are steadily gaining acceptance as risk factors, one of the most important of these being the Type A behaviour pattern. The far reaching consequences of Coronary Heart Disease have necessitated investigations into methods of decreasing contact with risk factors, particularly psychological ones. The substantial success of the Recurrent Coronary Prevention Project (Friedman et al), coupled with the promising results from other intervention studies, suggests that behaviour change is a viable goal in the prevention of heart disease. Following on from the Recurrent Coronary Prevention Project, Venter (1993) and Viljoen (1993) adapted it for the South African population. Although relatively successful, it did have its flaws. Thus the motivation for redesigning this intervention addressing its shortcomings The revised intervention was administered to a group of 25 Coronary Heart Disease patients. A second group of 22 patients were subjected to the intervention utilised in the original South African Recurrent Coronary Prevention Project. A third group of 18 patients served as a waiting list control group. The results indicated that although the revised intervention produced larger changes in Type A behaviour than the original South African Recurrent Prevention Project intervention, these differences were not significant. Possible reasons for this were the measures utilised, the sample sizes and the nature of the groups themselves. However, the revised version of the SARCPP was found to be more effective in the reduction of the hostility and anger components of the behaviour pattern than the original version. In conclusion it was found that before any further research in this area be conducted, the measures utilised should be modified and the mechanisms of treatment effect be examined.

Identiferoai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:uj/uj:9254
Date14 August 2012
CreatorsMaclennan, Nicole
Source SetsSouth African National ETD Portal
Detected LanguageEnglish
TypeThesis

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