Psychosocial predictors of recovery after a myocardial infarction: Development of a comprehensive assessment method

Abstract

A comprehensive self-report questionnaire was constructed for the assessment of psychological risk factors in coronary patients during the acute care phase. Factors assessed were reactive anxiety and depression. coping with illness. Type A behaviour, anger, and work stress. Based on these measures a risk index was created. The validity of the method was examined in a clinical trial. Baseline data including social and medical information was collected in three hospitals. The sample comprised 243 patients, aged under 60 years, who were hospitalised because of a myocardial infarction. A 12 month follow-up was conducted by a mailed questionnaire. Results showed a 3% total mortality and successful return to work was recorded in 54% of the subjects during the year. Of the measures included on the risk index, the two coping subscales, depressive resignation and denial of illness, were the best separate predictors of both return to work and self-rated health after 12 months. The dichotomised psychological risk index was also statistically significantly (p < 0.001) associated with return to work after 12 months. Results indicate that this method could be a useful instrument for both clinical practice and research in cardiac rehabilitation.