Out of 27 patients in each group of intervention and control, 77.8% were male and 22.2% were female. The mean age of patients was 56.85 ± 7.21 years in the intervention group and 56.56 ± 7.56 years in the control group. In addition, 40.8% did not have a high school diploma, 16.7% were high school graduates, 24.1% had higher education, and only 18.5% were illiterate. In terms of employment, 33.3% were retired, 33.3% were employed, 20.4% were housewives, and the rest were unemployed. There was no significant difference between the two groups in terms of mean age, sex, literacy, and employment status. None of the groups suffered from mental problems or diseases other than cardiac disease.
There was no significant difference between the two groups in mean scores of awareness, attitude, skills, self-help behaviors, and depression before the intervention. However, the values significantly differed after the intervention. Awareness and attitude toward risk factors of atherosclerosis, CABG surgery, depression symptoms, and preventive methods such as walking, relaxation, exercising, formation of a supportive system, and participation in cardiac rehabilitation program were considered as predisposing causes in which there were no significant differences between the two groups before the educational intervention (P < 0.0001). After the intervention however, the same values significantly differed between the two groups. Educational resources included educational pamphlets, trainers, psychologists, rehabilitation nurses, educational classes, relaxation educational tapes, educational films about appropriate exercises for cardiac patients, pictures and educational slides about appropriate and deep breathing after the surgery, and rehabilitation programs. Although there were no significant differences in using educational resources between the two groups before the intervention, significant increases were observed in application of the resources in the intervention group immediately after the intervention and even at the second month. However, little change was detected in the control group (P < 0.0001).
The trained skills included walking, exercising, relaxation, breathing exercises, formation of a supportive system with a group of patients who participated in the program, and learning how to measure heart rate during physical activity. These skills, considered as enabling causes, were not significantly different between the two groups before the intervention. However, there was a significant difference between the two groups after the educational intervention (P < 0.001) ().
Comparing the mean scores of awareness, attitude, skills, behaviors, and depression between the two groups
Before the intervention, most patients of both groups lacked the skills of walking, exercising, relaxation, deep breathing exercises, and formation of supportive system (P > 0.05). After the intervention however, most patients of the intervention group fully or partly learned the mentioned skills and a significant difference was found between the two groups (P < 0.0001) (). Before the educational intervention, the reinforcing causes (encouragement of others) after self-help behaviors were almost absent in both groups (P > 0.05). However, encouragement of others after the educational intervention increased behaviors to prevent depression and made a significant difference between the two groups (P < 0.001).
Comparing the frequency of implementing the skills between the intervention and control groups
Although most patients of both groups never or sometimes conducted self-help behaviors before the educational intervention, most patients of the intervention group always or often performed the trained self-help behaviors after the intervention and a significant difference was detected between the two groups ().
Comparing the frequency distribution of behaviors preventing depression between the intervention and control groups
Before the intervention, mean scores of depression in the intervention and control groups were 112.8 ± 21.9 and 104.5 ± 30.4, respectively (P > 0.05). Immediately and 2 months after the intervention, the mean scores of depression in the intervention group decreased to 78.4 ± 17.4 and 66.2 ± 22 (41% reduction), respectively (P < 0.001). In the control group, mean score of depression had a significant reduction to 89.2 ± 27.8 two months after the intervention (14% reduction) (P < 0.001).