Psychosocial adjustment in patients after a first acute myocardial infarction: The contribution of salutogenic and pathogenic variables

Yaacov Drory, Shlomo Kravetz, Victor Florian, Yaacov Drory, Uri Goldbourt, Hanoch Hod, Elieser Kaplinsky, Z. Enrique Fisman, Michael Motro, Tel Hashomer, Yeheskiel Kishon, Michael Kriwisky, Daniel David, Hana Pauzner, Itzhak Shapira, Amos Pines, Margalit Drory, Arie Roth, Shlomo Laniado, Zvi SchlesingerAlejandro Solodky, Samuel Sclarovsky, Izhar Zahavi, Menachem Caneti, Ron Leor, Victor Florian

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To ascertain the differential and independent impact of sociodemographic, 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, medical, and psychologic data were elicited at the first interview and completed from medical information in the hospital files. Psychosocial adjustment in seven significant life domains was evaluated by the Psychosocial Adjustment 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 psychosocial 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 psychosocial adjustment in most PAIS-SR-measured life domains. Low to moderate relations were found between such medical variables as Killip class, heart disease before AMI, other medical conditions, and perceived health before first AMI and psychosocial adjustment in specific life domains. The results also raised the possibility that part of the impact of the medical variables at discharge on psychosocial adjustment 3 to 6 months later may have been mediated by the psychologic variables. The centrality of the psychologic and domestic life domains to psychosocial adjustment in post-AMI patients was also suggested by the results. Conclusions: Both external and internal pathogenic (depression) and health proneness variables (sense of coherence and social support) at discharge predict psychosocial adjustment in most life domains 3 to 6 months after AMI.

Original languageEnglish
Pages (from-to)811-818
Number of pages8
JournalArchives of Physical Medicine and Rehabilitation
Volume80
Issue number7
DOIs
StatePublished - Jul 1999

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