Abstract
Aim. This study was conducted to determine the effect of cognitive-behavioral rehabilitation based on stress immunization training on anxiety, stress and depression in patients with coronary artery bypass graft surgery.
Background. Stress, anxiety and depression that play an important role in coronary artery disorders, are being considered as a hindrance to recovery after CABG. Providing the patient with correct coping strategies with stress seems to be helpful in preventing the recurrence.
Method. The study was a quasi-experimental with control group with pretest-posttest design. The statistical population of this study included patients who had coronary artery bypass graft surgery and referred to the Rehabilitation center of Tehran Heart Hospital, Tehran, Iran. Thirty subjects were selected by continuous sampling method and randomly assigned into experimental and control group. The instruments for data collection were “Depression, Anxiety and Stress Scale” (DASS-21), which completed before and after the intervention. The experimental group was exposed to stress immunization training in 10 sessions of 90 minutes. To analyze the data, multivariate covariance analysis, and one-variable covariance analysis were used in SPSS software.
Findings. Stress immunization training significantly influenced the anxiety (p≤0.0001; F=0.39), stress (p≤0.0001; F=0.35), and depression (p≤0.0001; F=0.68) scores of the experimental group compared to the control group.
Conclusion. Stress immunization training plays an important role in reducing negative emotions (anxiety, stress and depression) in patients with coronary artery bypass graft surgery. It is recommended to use this intervention for patients undergoing CABG.

Abstract
Aim. This study was conducted to compare the effect of multidimensional spiritual therapy and stress inoculation training (SIT) on physiological and psychological coordination of heart rate variability (HRV) and depression in patients after coronary artery bypass graft (CABG) surgery.
Background. Depression and other emotional disorders play an important role in reducing the physiological and psychological coordination of heart rate in patients after coronary artery bypass graft (CABG) surgery. Depression and other emotional disorders prevent the person from recovering from the pathologic condition. It seems that preparing the patient for proper coping techniques is helpful in improving emotional disorders and preventing recurrence of disease.
Method. This was a clinical trial with two experimental and one control group. The study population included patients after CABG in Tehran Cardiac Research Center, Tehran, Iran. Thirty patients were randomly selected and assigned into three groups. The instrument of this study was the DASS-21 scale and the evaluation of physiological and psychological coordination of heart rate, which was measured before the intervention and at the end of the 10th session in groups. The first experimental group was exposed to the Meichenbaum stress inoculation training for 10 sessions of 90-minute duration, and the second experimental group received multidimensional spiritual therapy. Data were analyzed using Multivariate analysis of covariance in SPSS.
Findings. Multivariate analysis of covariance showed that SIT and multidimensional spiritual therapy interventions both have a statistically significant effect in reducing depression in one-month and three-month follow-up, compared to the control group, but their effects on reducing depression was significantly different (-2.200, P=0.002). However, no statistically significant difference was observed between experimental groups in terms of changes in physiological and psychological coordination (-0.00133, P=0.1).
Conclusion. SIT intervention seems to be less effective than multidimensional spiritual therapy in reducing depression, but its effect on changes in physiological and psychological coordination is the same as multidimensional spiritual therapy.