The demographic characteristics that are associated with improved mental health of cardiac disease patients are not necessarily good for their physical health, And, while cardiac patients were found to have mental health scores that approximately equaled the mental health scores of the general population, physical health scores of coronary patients were nearly 48% below those of the general population.

In a study of over 3,000 coronary patients during the three years after their original diagnosis, psychologist Hayden Bosworth, Ph.D., and his colleagues at the Duke University Medical Center found that being older, male, college educated, a minority, and having increased social support were all related to improved mental well-being in cardiac patients.

But, being female and having less social support were associated with improved physical component scores. Component scores were determined through the use of a number of survey instruments that measured health-related quality of life issues such as general health perceptions, general mental health, physical functioning, limitations due to health, and vitality. Oddly enough, having more social support was helpful to mental well-being but was a negative influence on their physical well-being. Not all social relationships are supportive, the authors theorize, and some may cause the patient to become overly dependent or may limit them physically.

As would be expected, having less serious cardiac disease was associated with both increased mental and physical well-being for all patients.

Age was another factor that was related to improved mental health but not improved physical health. Older patients scored higher on measures of health- related quality of life." Older patients, the authors state, "may show better mental health than younger patients because the onset of chronic illness in old age is more usual and subsequently, possibly less disruptive than in younger adults. In addition, older persons may have developed more effective skills with which to manage health deficits."

Finally, minority patients had higher levels of mental component scores than did white patients; and there were no race differences for physical health scores between minority and majority patients.

Overall health-related quality of life measures for coronary patients tended to improve during their first year of treatment but then level off during years two and three, rather than continue to improve. Despite treatment, whether medical or surgical, most cardiac patients did not show substantial improvement in their quality of life measures after three years. The authors recommend that cardiac patients should receive continued treatment and more intensive postoperative follow-up for potentially up to three years from the original diagnosis.

11/03/00

Hayden Bosworth, Ph.D., can be reached at his Duke University office at (919) 286-6963.