Web-based Psychological Intervention to Coronary Artery Heart Disease Patients

Development and Evaluation of a Web-based Group Cognitive-behavioral Therapy Program for Coronary Artery Heart Disease Patients

The purpose of this study is to evaluate medical cost-effectiveness, reduce the psychological risk factors( including hostility, anxiety, depression, and perceived stress) in coronary artery disease (CAD) patients and enhance the regulation of the autonomic nervous system (including respiration rate, heart rate, distal blood vessel pulse, and finger temperament) through web-based cognitive -behavioral group therapy.

Cognitive-behavioral therapy (CBT) is effective in reducing the level of anger, hostility and depression present in coronary artery disease (CAD) patients.In Taiwan, Weng et al. also confirmed the eight-week group CBT program not only diminished the emotion disturbances including anger, hostility and depression of CAD, but also significantly prolonged the coagulation time, thus reducing the rate of thrombosis formation. Even though the therapeutic effect of the CBT program was valid, this program is still not accessible for some patients in need because they are not aware of it, or they are restricted by time and transportation. Internet-based therapeutic intervention can overcome the obstacles to access this program at any time and in any place. Presently, structured CBT intervention is provided through the Internet and used widely by patients with physical or psychological problems such as smoking, obesity, or headaches, but not by CAD patients. Therefore, the purpose of this research is to evaluate the effects to reduce the psychological risk factors of a web-based group CBT program in CAD patients. Follow-up assessments will be performed after 3 and 6-month durations. The investigators expect that, after an eight-week group intervention, there will be significant decrease of the psychological risk factors. Moreover, the therapeutic effects can be maintained during the three- and six-month follow-up.evaluate In addition, web-based cognitive -behavioral group therapy will significantly reduce indirect medical costs (travel time and money).

Significant decrease of the psychological risk factors in web-based group CBT intervention group after an eight-week group intervention

Evaluate the effects to reduce the psychological risk factors and enhance the regulation of automatic nerve system： Time point：Post-intervention, 3 months, and 6 months follow up Subjective (self report inventories), including hostility, anxiety,and perceived stress. Objective (Biofeedback devices):including blood vessel pulse, EKG, skin conductance, ect.

Evaluate indirect medical cost-effectiveness (travel time and money) during web-based Psychological Interventions

Psychosocial risk factor and characteristic cardiovascular responses present present in CAD patients on pre-group intervention

Time point：Pre-group intervention Subjective (self report inventories), including hostility, anxiety,and perceived stress. Objective (Biofeedback devices):including blood vessel pulse, EKG, skin conductance, ect.