The Effect of a brief relaxation response intervention on physiologic markers of stress in patients hospitalized with coronary artery disease

Abstract

Activation of the neuroendocrine response to stress results in numerous physiologic changes that can have an untoward effect on glucose levels anJ hemodynamic status, especially in the patient hospitalized with coronary artery disease (CAD). This experimental study tested the effects of a brief, nurse-delivered relaxation response (RR) intervention on physiologic markers of stress including capillary blood glucose (CBG), heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP) and rate-pressure product (RPP) in addition to self-reported stress levels (SRSL) in patients hospitalized with CAD. In this randomized clinical trial, subjects (n = 48) were assigned to either the experimental or control group, Pretest measures of CBG, HR, SBP, DBP, RPP and SRSL were obtained for all subjects. Subjects in the experimental group were taught to elicit the RR and asked to practice the technique for 20 minutes. Subjects in the control group were instructed to rest quietly for 20 minutes. Posttest measures ofCBG, HR, SBP, DBP, RPP and SRSL were obtained for all subjects following the 20 minute study period. Multivariate analysis of covariance (MANCOV A) demonstrated a significant difference in adjusted mean scores between the experimental and control group (p = .002). Follow-up univariate analyses of covariance demonstrated significant decreases in CBG (p = .008), HR (p = .024) and RPP (p = .044) in the group receiving the relaxation response intervention. The findings indicated that in patients hospitalized with CAD, a brief, nurse-delivered relaxation response intervention was more effective in lowing CBG, HR and RPP than a usual care approach. Thus, a brief, nurse-delivered relaxation response intervention may prove a novel method for hemodynamic and metabolic modulation of the stress response to include the prevention and treatment of stressinduced hyperglycemia among patients hospitalized with CAD.