UPBEAT study patients' perceptions of the effect of coronary heart disease on their lives: a cross-sectional sub-study

Smith, Alison, Fortune, Zoe, Phillips, Rachel, Walters, Paul, Lee, Geraldine A., Mann, Anthony, Tylee, Andre and Barley, Elizabeth (2014) UPBEAT study patients' perceptions of the effect of coronary heart disease on their lives: a cross-sectional sub-study. International Journal of Nursing Studies, 51 (11). pp. 1500-1506. ISSN 0020-7489

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Abstract

Background

Patients can report positive effects of myocardial infarction. It is unknown whether these effects are sustained or what factors influence adaptation.

Objectives

To explore primary care patients’ perceptions of the effect of coronary heart disease and to identify possible modifiable predictors of adaptation.

Design and setting

Cross-sectional, sub-study of UPBEAT cohort participants. Patients were recruited from coronary heart disease Registers in South London General Practices.

Method

548 participants were asked “Has having heart disease changed your life? If so, was that change for the better, worse, both or neither?” Participants were asked to explain their response; explanations were subjected to content analysis. Associations between response and lifestyle, demographic, mood and coronary heart disease variables were tested.

Results

Respondents (394 male, 72%) were aged 27–98 years and had had heart disease for a mean of 12.4 SD ± 8.4 years. 120 (22%) reported that life was better and 200 (37%) said it was worse. The explanations of those who said ‘better’ were categorised as ‘Healthier Living’, ‘Recognised Mortality’ and ‘Stress Reduction’. For those saying ‘worse’, categories were ‘Restricted Lifestyle’, ‘Recognised Mortality’, ‘Loss and Burden’. More anxiety symptoms (RRR 1.56, 95% CI 1.12, 2.17), lower functional status (RRR 2.46, 95% CI 1.21, 4.98) and self-reported chest pain (RRR 2.24, 95% CI 1.34, 3.77) were associated with saying ‘worse’.

Conclusions

Many primary care patients are ambivalent to the effects of coronary heart disease, but some report positive effects. Negative perceptions are associated with reported functional impairment, chest pain and anxiety, but not illness severity or patient characteristics. Future work will track the implications of these perceptions, but nurses managing patients with coronary heart disease should consider these effects as they may be modifiable predictors of adaptation.

Item Type: Article
Subjects: Medicine and health > Mental health
Medicine and health > Nursing
Depositing User: Elizabeth Barley
Date Deposited: 02 Jun 2016 11:00
Last Modified: 07 Jul 2017 12:38
URI: http://repository.uwl.ac.uk/id/eprint/2345

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