Functional decline after congestive heart failure and acute myocardial infarction and the impact of psychological attributes. A prospective study

This article examines the influence of three pre-morbidly assessed psychological attributes (i.e. neuroticism, mastery and self-efficacy expectancies) on functional decline after congestive heart failure (CHF; n = 134) and acute myocardial infarction (AMI; n = 79) in late middle-aged and older persons. Due to the prospective design of the study initial baseline levels of functional disability and number of chronic medical conditions could be adjusted, next to age, gender and the severity of either CHF or AMI. Functional disability was re-assessed 8 weeks after the diagnosis of either CHF or AMI. Significant unique contributions of self-efficacy expectancies were found for functional decline after CHF, while mastery significantly contributes to functional decline after AMI: those patients with higher levels of mastery or self-efficacy expectancies showed less decline. In conclusion, pre-morbidly assessed psychological attributes substantially influence functional decline after cardiac disease in late middle-aged and older persons, but the impact of specific attributes is somewhat different for CHF and AMI

Pre-morbid predictors of psychological adjustment to cancer

This study examined the potential role of social support, neuroticism, and self-efficacy as predictors of the short-term and long-term adaptation to the diagnosis of cancer. Psychological adjustment was defined in terms of psychological distress. It is argued that these factors may provide insights that might be helpful in the provision of medical care to patients. We hypothesized that they would be especially predictive of long-term psychological adjustment. The study was conducted in a truly prospective design with one pre-morbid assessment and two post-morbid assessments used in the present analyses. Participants of a baseline assessment among 5279 subjects (aged 57 years and older) in 1993 were monitored for cancer incidence by their general practitioners. The study sample included 99 cancer patients who had completed all pre- morbid and post-morbid assessments. Multivariate analyses revealed that high neuroticism was associated with higher levels of distress in the short- and long-term. Higher levels of social support were associated with higher levels of distress in the long-term. The direction of this association was opposite to what might be expected on the basis of the literature. Implications of the findings for health care as well as explanations for the social support findings are discussed

Functional decline after congestive heart failure and acute myocardial infarction and the impact of psychological attributes. A prospective study

This article examines the influence of three pre-morbidly assessed psychological attributes (i.e. neuroticism, mastery and self-efficacy expectancies) on functional decline after congestive heart failure (CHF; n = 134) and acute myocardial infarction (AMI; n = 79) in late middle-aged and older persons. Due to the prospective design of the study initial baseline levels of functional disability and number of chronic medical conditions could be adjusted, next to age, gender and the severity of either CHF or AMI. Functional disability was re-assessed 8 weeks after the diagnosis of either CHF or AMI. Significant unique contributions of self-efficacy expectancies were found for functional decline after CHF, while mastery significantly contributes to functional decline after AMI: those patients with higher levels of mastery or self-efficacy expectancies showed less decline. In conclusion, pre-morbidly assessed psychological attributes substantially influence functional decline after cardiac disease in late middle-aged and older persons, but the impact of specific attributes is somewhat different for CHF and AMI