Y. Drory et al., Psychosocial adjustment in patients after a first acute myocardial infarction: The contribution of salutogenic and pathogenic variables, ARCH PHYS M, 80(7), 1999, pp. 811-818
Objective: To ascertain the differential and independent impact of sociodem
ographic, medical, and psychologic variables assessed at patients' hospital
discharge on these patients' psychosocial adjustment in several domains of
life 3 to 6 months later.
Design: Two-hundred ninety Israeli male patients, aged 30 to 65 years, with
a documented first acute myocardial infarction (AMI) were interviewed once
before discharge and again 3 to 6 months postinfarct. Sociodemographic, me
dical, and psychologic data were elicited at the first interview and comple
ted from medical information in the hospital files. Psychosocial adjustment
in seven significant life domains was evaluated by the Psychosocial Adjust
ment to Illness Scale-Self-Report Version (PAIS-SR) at the second interview
. Hierarchical regression analysis was used to examine the relation between
the sociodemographic, medical, and psychologic variables at discharge to p
sychosocial adjustment in the different life domains 3 to 6 months later.
Results: Psychologic variables, such as depression, sense of coherence, and
social support, and the sociodemographic variable of educational level at
discharge predicted a relatively substantial amount of variance in psychoso
cial adjustment in most PAIS-SR-measured life domains. Low to moderate rela
tions were found between such medical variables as Killip class, heart dise
ase before AMI, other medical conditions, and perceived health before first
AMI and psychosocial adjustment in specific life domains. The results also
raised the possibility part of the impact of the medical variables at disc
harge on psychosocial adjustment 3 to 6 months later may have been mediated
by the psychologic variables. The centrality of the psychologic and domest
ic life domains to psychosocial adjust ment in post-AMI patients was also s
uggested by the results.
Conclusions: Both external and internal pathogenic (depression) and health
proneness variables (sense of coherence and social support) at discharge pr
edict psychosocial adjustment in most life domains 3 to 6 months after AMI.
(C) 1999 by the American Congress of Rehabilitation Medicine and the Ameri
can Academy of Physical Medicine and Rehabilitation.