Background: Previous research indicates that for some individuals, quality of life (QoL) post-cardiac surgery (CABG or PTCA ) declines from pre-surgery levels. Using the framework of Leventhal's Common-Sense Model, this longitudinal study examined the associations between patients' illness perceptions and coping strategies, their QoL, attendance at cardiac rehabilitation and lifestyle changes. It was hypothesised that a more negative profile of illness beliefs (weaker control beliefs, belief in more severe consequences, poorer understanding of the condition, and negative emotional representations) together with the use of more emotional coping strategies would be associated with poorer QoL. It was also hypothesised that attendance at cardiac rehabilitation would be associated with greater control beliefs, more severe consequences and a causal attribution of lifestyle. Sample and Methods: 113 patients (93 male, mean age 66 (8.93) who were about to undergo cardiac surgery were recruited from two hospitals. Questionnaire measures of illness perceptions (IPQ-R), coping (CHIP) and cardiac-specific QoL (MacNew) were administered at four time points: pre-surgery, post-surgery, post cardiac rehabilitation, and one-year follow up. Data on attendance at rehabilitation and health behaviours were collected via hospital records and patient report. Results: The best predictors of QoL were not cognitive representations of the cardiac problems, but negative emotional representations and associated emotion-focussed coping strategies, implying that an emotion-regulation intervention could be targeted to improve outcome. The predictive ability of initial QoL on QoL at later stages implies this might be best introduced pre-surgery. Having less severe consequence beliefs prior to surgery predicted greater attendance at cardiac rehabilitation. A better understanding of the cardiac condition predicted attendance at cardiac rehabilitation. There was no evidence of change in lifestyle post-rehabilitation.Discussion: The findings that emotional representations of cardiac problems and the use of emotion focussed coping strategies were predictors of quality of life suggest that interventions to foster adaptive emotion regulation may improve outcome in these patients. Findings with respect to attendance at rehabilitation varied somewhat from the previous literature, possibly because the present study sampled patients who were having elective surgery, rather than those who had recently had a heart attack. The importance of studying defined populations and also the issue of when measures are obtained in relation to cardiac events were also highlighted.

Tyrimo tikslas – nustatyti galimas sąsajas tarp kiekvieno asmenybės stiliaus aukštesnio išreikštumo ir ligos suvokimo ypatumų, lyginant su kiekvieno asmenybės stiliaus žemesnio išreikštumo grupės ligos suvokimo ypatumais. Tyrime dalyvavo 190 VšĮ Ukmergės ligoninės Fizinės medicinos ir reabilitacijos skyriuje besigydančių pacientų (vyrų ir moterų). Siekiant įvertinti tiriamųjų asmenybės stiliaus išreikštumo bei ligos suvokimo sąsajas, tiriamiesiems išdalinti klausimynai, kuriuos jie pildė namuose ir grąžino tyrėjui. Tyrime naudoti du klausimynai: Ligos suvokimo klausimyno (Illness Perception Questionare, IPQ; Weinman ir kt., 1996) atnaujinta versija (IPQ-R) ir pagal DSM-IV-R klasifikaciją sudarytas klausimynas asmenybės stilių išreikštumui nustatyti. Tyrimo rezultatai parodė, kad aukštesnio išreikštumo vengiančiam, priklausomam, šizoidiniam, paranoidiniam, histrioniniam, ribiniam asmenybės stiliams būdingas didesnis tapatinimasis su liga, lyginant su žemesnio išreikštumo asmenybės stilių tapatinimusi su liga; aukštesnio išreikštumo vengiančio, priklausomo, paranoidinio, histrioninio, obsesinio-kompulsinio asmenybės stilių požiūris į ligą negatyvesnis, lyginant su žemesnio išreikštumo asmenybės stilių požiūriu į ligą; aukštesnio išreikštumo vengiantis, priklausomas, paranoidinis, histrioninis, ribinis, obsesinis-kompulsinis asmenybės stiliai patiria daugiau nuo ligos suvokimo skirtumų priklausančių neigiamų emocijų, kurios turi įtakos su sveikata susijusio elgesio... [toliau žr. visą tekstą] / The aim of the study was to examine the relations between every highly expressed personality style and illness perception peculiarity comparing with lower expressed personality style and illness perception peculiarity. 190 patients from Ukmerge Hospitals Physical Medicine and Rehabilitation centre were examined in this experiment (both men and women). In order to examine relations between expressed personality style and illness perception, every patient had to complete the questionnaire at home and bring it back researcher. Two questionnaires were used in this experiment: Illness Perception Questionnaire, IPQ (Weinman ir kt., 1996) new version IPQ – R and questionnaire to identify expressed personality style which was created based on DSM – IV – R. The results showed that: patients with higher expressed personality style (avoiding, depending, paranoid, schizoid, borderline personalities) have higher identification with illness, comparing with lower expressed personality style patients; patients with higher expressed personality style (avoiding, depending, paranoid, histrionic, anancastic personalities) have more negative attitude towards illness, comparing with lower expressed personality style patients; patients with higher expressed personality style (avoiding, depending, paranoid, histrionic, borderline and anancastic personalities) experience more negative emotions related to illness perception which influence health related behavior, comparing with lower expressed... [to full text]

Health related outcomes for individuals with chronic symptoms of illness can be influenced by complex, socio-emotional processes. The primary interest of this study was to determine whether perceived social support lessens the negative emotional appraisals of illness experience (e.g. anger, fear, hostile interpretations of illness), and the role of these emotional appraisals in health outcomes for those diagnosed either with a conventional chronic illness (e.g. diabetes, arthritis, chronic obstructive pulmonary disease) or a functional somatic syndrome (e.g. fibromyalgia, chronic fatigue syndrome, irritable bowel). Data for this study were collected from a series of four surveys administered online, which included measures of perceived social support (MSPSS), emotional representations of illness (IPQ-R), and health outcomes (SF-36). The sample included 151 participants (129 Female, 22 Male), all of whom experienced chronic somatic symptoms for at least 3 months, with 57 classified as having a conventional diagnosis (CD) and 94 with a functional somatic syndrome (FSS). The results suggest a potential mechanism for the buffering effect of social support, such that those with higher levels of social support reported lower degrees of emotional representations. After controlling for demographic and illness-related variables, social support was a significant predictor of emotional representations of illness. Emotional appraisals of physical symptoms predicted a majority of the health dimensions of the SF-36; including social functioning, role limitations due to physical problems and emotional problems, emotional well-being, vitality, and overall perception of general health. The pattern of findings underscores the need to consider the influence of psychosocial processes on both psychological and physical well-being in populations adjusting to chronic illness.