Mental consequences and behavioral health 18 month after outpatient cardiac rehabilitation in three separated profiles at baseline

Objectives The study aims to perform a cluster analysis on the mental health of patients at the cardiac rehabilitation (CR) baseline as well as attendance in sessions and to compare the mental health and healthy behaviors of the samples in an 18-month follow-up. Methods In the first phase of this longitudinal study, 148 CR patients in western Iran participated from January to April 2016. After completing the standard questionnaires, the participants attended 7–26 exercise sessions on average. Then, the cluster analysis was performed based on anxiety, depression, and the number of attended sessions. During the 18-month phone follow-up, 113 participants answered the other standard instruments. The long-term mental and behavioral consequences were compared among the derived clusters using ANOVA and Tukey post-hoc test. Results The average age of participants (69.9% male) was 59.3 ± 9.1. The analysis suggested three clusters: (i) patients with medium distress and weak participation, (ii) patients with mild distress and average participation, and (iii) patients with medium distress and good participation. While there was no significant difference among the clusters with regards to healthy behaviors and mortality rate, the difference was significant with regards to psychological distress, somatic symptoms, duration and quality of sleep, and general quality of life (P < 0.05). Conclusion Initial distress and weak participation of outpatients in CR has more severe long-term somatic and psychological consequences. Screening of increased psychological distress and identification of candidates for failure to adhere to CR at the baseline are considered among the most important responsibilities of the CR team.