The effect of education based on the main concepts of logotherapy approach on the quality of life in patients after coronary artery bypass grafting surgery

Mostafa Mahdizadeh, Mousa Alavi, Zahra Ghazavi


Background: Improving the patients’ quality of life (QOL) after coronary artery bypass grafting (CABG) is one of the main concerns of the treatment team. Educational interventions may affect the aspects of QOL in various ways. The present study aimed to investigate the effect of education based on the main concepts of logotherapy approach on the CABG patients’ quality of life.

Materials and Methods: In this quasi‑experimental study, a convenient sample of 67 patients who had undergone CABG in Isfahan Chamran hospital were randomly allocated to two groups of experimental (n = 35) and control (n = 32). While the control group received routine care, the experiment group benefitted from logotherapy‑based education program (six 90‑min sessions, twice a week). SF‑36 questionnaire was completed by both two groups (before and 1 month after intervention). Descriptive and inferential statistical tests (consisting of independent t‑test) were employed to analyze data in SPSS version 13.

Results: The pre‑test mean total score of SF‑36 questionnaire and also the mean scores of its eight dimensions were not significantly different between the two groups. The post‑test mean score change [Standard Error (SE)] in the intervention group was 24.95 (3) and in the control group was 9.27 (0.82). There were significant differences between the two groups (P < 0.001). Moreover, the mean scores of six dimensions of QOL (vitality, bodily pain, general health, emotional role, social functioning, and mental health) changed significantly in the intervention group.

Conclusions: Our findings indicated that the intervention has improved the patients’ QOL after CABG. Integration of such an intervention in these patients’ rehabilitation programs is recommended.



Coronary artery bypass; coronary artery bypass graft; education; Iran; logo therapy; quality of life

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He L, Tang X, Song Y, Li N, Li J, Zhang Z, et al. Prevalence of cardiovascular disease and risk factors in a rural district of Beijing, China: A population‑based survey of 58,308 residents. BMC Public Health 2012;12:34.

WHO. Cardiovascular diseases (CVDs). 2012; Available from: [Last accessed on 2013 Feb 18].

Le Grande MR, Elliott PC, Murphy BM, Worcester MU, Higgins RO, Ernest CS, et al. Health related quality of life trajectories and predictors following coronary artery bypass surgery. Health Qual Life Outcomes 2006;4:49.

Rollman BL, Belnap BH, LeMenager MS, Mazumdar S, Houck PR, Counihan PJ, et al. Telephone‑delivered collaborative care for treating post‑CABG depression: A randomized controlled trial. JAMA 2009;302:2095‑103.

Rothenhausler HB, Grieser B, Nollert G, Reichart B, Schelling G, Kapfhammer HP. Psychiatric and psychosocial outcome of cardiac surgery with cardiopulmonary bypass: A prospective 12‑month follow‑up study. Gen Hosp Psychiatry 2005;27:18‑28.

Rumsfeld JS, Ho PM, Magid DJ, McCarthy M Jr, Shroyer AL, MaWhinney S, et al. Predictors of health‑related quality of life after coronary artery bypass surgery. Ann Thorac Surg 2004;77:1508‑13.

Thornton EW, Groom C, Fabri BM, Fox MA, Hallas C, Jackson M. Quality of life outcomes after coronary artery bypass graft surgery: Relationship to neuropsychologic deficit. J Thorac Cardiovasc Surg 2005;130:1022‑7.

Škodová Z, van Dijk JP, Nagyova I, Rosenberger J, Ondušova D, Middel B, et al. Psychosocial predictors of change in quality of life in patients after coronary interventions. Heart Lung 2011;40:331‑9.

Hawkes AL, Nowak M, Bidstrup B, Speare R. Outcomes of coronary artery bypass graft surgery. Vasc Health Risk Manag 2006;2:477‑84.

Fitzpatrick JJ, Kazer M. Encyclopedia of nursing research. 3rd ed. New York: Springer Publishing Company 2011. p. 90.

Goyal TM, Idler EL, Krause TJ, Contrada RJ. Quality of life following cardiac surgery: Impact of the severity and course of depressive symptoms. Psychosom Med 2005;67:759‑65.

Doering LV, Moser DK, Lemankiewicz W, Luper C, Khan S. Depression, healing, and recovery from coronary artery bypass surgery. Am J Crit Care 2005;14:316‑24.

Oxlad M, Stubberfield J, Stuklis R, Edwards J, Wade TD. Psychological risk factors for cardiac‑related hospital readmission within 6 months of coronary artery bypass graft surgery. J Psychosom Res 2006;61:775‑81.

Mallik S, Krumholz HM, Lin ZQ, Kasl SV, Mattera JA, Roumains SA, et al. Patients with depressive symptoms have lower health status benefits after coronary artery bypass surgery. Circulation 2005;111:271‑7.

Wulsin L. Psychological challenges of coping with coronary artery disease. In: Dornelas EA, editor. Stress proof the heart: behavioral interventions for cardiac patients. New York: Springer; 2012. p. 9‑24

Dehdari T, Heydarnia A, Ramezankhani A, Sadeghian S, Ghofranipoor F, Etemadi S. Planning and evaluation of an educational intervention programme to improve life quality in patients after coronary artery bypass graft‑surgery according to PRECEDE‑PROCEED model. J Birjand Univ Med Sci 2009;15:27‑37.

Fegg MJ, Brandstätter M, Kramer M, Kögler M, Haarmann‑Doetkotte S, Borasio GD. Meaning in life in palliative care patients. J Pain Symptom Manage 2010;40:502‑9.

Shoaa‑Kazemi M, Saadati M. The study of effective logotherapy training on reductionhopelessness in brest cancer women’s in tehrancity. Iran Q J Breast Dis 2010;3:40‑8.

Gholami M, Pasha G, Sodani M. To investigate the effectiveness of group logotherapy on the increasement of life expectancy and health on female teenager major thalassemia patients of Ahvaz city. Knowledge 2010;11:23‑42.

Ghanbari ZZ, Goudarzi M. The impact of group counseling in logotherapy method for the improvement of general health of female victims of earthquake. J Womens Stud 2009;2:57‑66.

Asghari N, Aliakbari M, Dadkhah A. The effects of group logotherapy on decreasing the degree of depression in female olds. Middle East J Disabil Stud 2012;1:31‑8.

Hasanzadeh A, Zahrakar K, Zare M. The efficacy of group conseling by the method of logotherapy in reducing hopelessness among the spinal cord injured handicapps, after the Zarand earthquake. Psychological Studies 2012;8:57‑62.

Kang KA, Im JI, Kim HS, Kim SJ, Song MK, Sim S. The effect of logotherapy on the suffering, finding meaning, and spiritual well‑being of adolescents with terminal cancer. J Korean Acad Child Health Nurs 2009;15:136‑44.

Kang KA, Shim JS, Jeon DG, Koh MS. The effects of logotherapy on meaning in life and quality of life of late adolescents with terminal cancer. J Korean Acad Nurs 2009;39:759‑68.

Mosalanejad L, Khodabakshi Koolee A. Looking at infertility treatment through the lens of the meaning of life: The effect of group logotherapy on psychological distress in infertile women. Int J Fertil Steril 2013;6:224‑31.

Schulenberg SE, Hutzell RR, Nassif C, Rogina JM. Logotherapy for clinical practice. Psychotherapy 2008;45:447‑63.

Mok E, Lau KP, Lai T, Ching S. The meaning of life intervention for patients with advanced‑stage cancer: Development and pilot study. Oncol Nurs Forum 2012;39:E480‑8.

Montazeri A, Goshtasebi A, Vahdaninia M, Gandek B. The short form health survey (SF‑36): Translation and validation study of the Iranian version. Qual Life Res 2005;14:875‑82.

Failde I, Ramos I. Validity and reliability of the SF‑36 Health Survey Questionnaire in patients with coronary artery disease. J Clin Epidemiol 2000;53:359‑65.

Ho MY, Cheung FM, Cheung SF. The role of meaning in life and optimism in promoting well‑being. Pers Individ Dif 2010;48:658‑63.

Hosseinzadeh‑Khezri R, Rahbarian M, Sarichloo ME, Lankarani KB, Jahanihashemi H, Rezaee F. Evaluation effect of Logotherapy group on Mental health and hope to life of patients with colorectal cancer receiving chemotherapy. Bull Env Pharmacol Life Sci 2014;3:164‑9.

Mendes de Leon CF, Czajkowski SM, Freedland KE, Bang H, Powell LH, Wu C, et al.; ENRICHD investigators. The effect of a psychosocial intervention and quality of life after acute myocardial infarction: The enhancing recovery in coronary heart disease (ENRICHD) clinical trial. J Cardiopulm Rehabil 2006;26:9‑15.

Fakhar F, Navabinezhad S, Foroughan M. The role of group counseling with logo‑therapeutic approach on the mental health of older women. SALMAND 2008;3:56‑65.

La Pier TK. Functional status of patients during subacute recovery from coronary artery bypass surgery. Heart Lung 2007;36:114‑24.


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