Skip to main content

Advertisement

SpringerLink
Log in

Resilience is strongly associated with health-related quality of life but does not buffer work-related stress in employed persons 1 year after acute myocardial infarction

  • Published:
Quality of Life Research Aims and scope Submit manuscript

Abstract

Purpose

Resilience may facilitate the adaptation after experiencing a severe disease such as acute myocardial infarction (AMI) and attenuate the negative effects of stress on health-related quality of life (HRQOL). However, it is unclear so far whether resilience moderates a negative association between work-related stress and HRQOL in employed patients after AMI.

Methods

Patients with confirmed AMI and regular paid employment admitted to a hospital in the study region of the MONICA/KORA Myocardial Infarction Registry, Germany (04/2014–06/2017) were included and completed questionnaires during their hospital stay and 6 and 12 months after discharge. The Resilience Questionnaire (RS-11) and the Effort–Reward Imbalance (ERI) Questionnaire were used to assess trait resilience and ERI, respectively. HRQOL was measured by the Short Form 36 Health Survey (SF-36) mental and physical component summary scales. Generalized estimating equations (GEE) adjusted for relevant potential confounding variables (demographic, social, stress-related, and clinical) were used to determine the association between resilience and HRQOL in the study course.

Results

From the 346 patients enrolled in the study, 270 patients (78.0%) had completed all surveys. High baseline trait resilience was significantly and independently associated with high physical HRQOL (ß = 0.15, p < 0.0001) and high mental HRQOL (ß = 0.37, p < 0.0001) 1 year post AMI. No significant interaction effects between trait resilience and ERI were found in the physical HRQOL GEE model (ß = 0.05, p = 0.7241) and in the mental HRQOL model (ß = 0.05, p = 0.3478).

Conclusions

The results demonstrated that trait resilience is independently and strongly related with post-AMI HRQOL but does not moderate the association between ERI and HRQOL.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Edmondson, D., Richardson, S., Falzon, L., Davidson, K. W., Mills, M. A., & Neria, Y. (2012). Posttraumatic stress disorder prevalence and risk of recurrence in acute coronary syndrome patients: A meta-analytic review. PLoS ONE,7, e38915.

    Article  CAS  Google Scholar 

  2. Bach, J. P., Riedel, O., Pieper, L., Klotsche, J., Dodel, R., & Wittchen, H. U. (2011). Health-related quality of life in patients with a history of myocardial infarction and stroke. Cerebrovascular Diseases,31, 68–76.

    Article  Google Scholar 

  3. Kuper, H., Singh-Manoux, A., Siegrist, J., & Marmot, M. (2002). When reciprocity fails: Effort-reward imbalance in relation to coronary heart disease and health functioning within the Whitehall II study. Occupational and Environmental Medicine,59, 777–784.

    Article  CAS  Google Scholar 

  4. Tzeng, D. S., Chung, W. C., Lin, C. H., & Yang, C. Y. (2012). Effort-reward imbalance and quality of life of healthcare workers in military hospitals: A cross-sectional study. BMC Health Services Research,12, 309.

    Article  Google Scholar 

  5. KORA Myocardial Infarction Registry. (2019). Mortality, mobidity, lethality, prior diseases, health care. http://www.gbe-bund.de/gbe10/abrechnung.prc_abr_test_logon?p_uid=gast&p_aid=0&p_knoten=FID&p_sprache=D&p_suchstring=6770::Myokardinfarkt. Accessed 19/07/2019.

  6. De Smedt, D., Clays, E., Annemans, L., et al. (2012). Health related quality of life in coronary patients and its association with their cardiovascular risk profile: Results from the EUROASPIRE III survey. International Journal of Cardiology,S0167–5273(12), 01428–01433.

    Google Scholar 

  7. Rutten, B. P., Hammels, C., Geschwind, N., et al. (2013). Resilience in mental health: linking psychological and neurobiological perspectives. Acta Psychiatrica Scandinavica,128, 3–20.

    Article  CAS  Google Scholar 

  8. Southwick, S. M., Bonanno, G. A., Masten, A. S., Panter-Brick, C., & Yehuda, R. (2014). Resilience definitions, theory, and challenges: interdisciplinary perspectives. European Journal of Psychotraumatology. https://doi.org/10.3402/ejpt.v5.25338.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Wagnild, G. M., & Young, H. M. (1993). Development and psychometric evaluation of the Resilience Scale. J Nursing Measurement,1, 165–178.

    CAS  Google Scholar 

  10. Windle, G., Bennett, K. M., & Noyes, J. (2011). A methodological review of resilience measurement scales. Health Quality Life Outcomes,9, 8.

    Article  Google Scholar 

  11. Chmitorz, A., Wenzel, M., Stieglitz, R.-D., et al. (2018). Population-based validation of a German version of the Brief Resilience Scale. PLoS ONE,13, e0192761.

    Article  Google Scholar 

  12. Friborg, O., Hjemdal, O., Rosenvinge, J. H., & Martinussen, M. (2003). A new rating scale for adult resilience: What are the central protective resources behind healthy adjustment? International Journal of Methods Psychiatric Research,12, 65–76.

    Article  Google Scholar 

  13. Stewart, D. E., & Yuen, T. (2011). A systematic review of resilience in the physically Ill. Psychosomatics,52, 199–209.

    Article  Google Scholar 

  14. Bergman, E., Arestedt, K., Fridlund, B., Karlsson, J. E., & Malm, D. (2012). The impact of comprehensibility and sense of coherence in the recovery of patients with myocardial infarction: A long-term follow-up study. European Journal of Cardiovascular Nursing,11, 276–283.

    Article  Google Scholar 

  15. Wrześniewski, K., & Włodarczyk, D. (2012). Sense of coherence as a personality predictor of the quality of life in men and women after myocardial infarction. Kardiologia Polska,70, 157–163.

    PubMed  Google Scholar 

  16. Siegrist, J., Starke, D., Chandola, T., et al. (2004). The measurement of effort-reward imbalance at work: European comparisions. Social Science and Medicine,58, 1483–1499.

    Article  Google Scholar 

  17. Karasek, R. (1979). Job demands, job decision latitude, and mental strain: Implications for job redesign. Administrative Science Quarterly,24, 285–308.

    Article  Google Scholar 

  18. Walker-Bone, K., D’Angelo, S., Stevens, M., et al. (2018). Job stress and post-retirement health in the Hertfordshire Cohort Study. Occupational Medicine (Lond),68, 572–579.

    Article  CAS  Google Scholar 

  19. Meisinger, C., Hörmann, A., Heier, M., Kuch, B., & Löwel, H. (2006). Admission blood glucose and adverse outcomes in non-diabetic patients with myocardial infarction in the reperfusion era. International Journal of Cardiology,113, 229–235.

    Article  Google Scholar 

  20. Schumacher, J., Leppert, K., Gunzelmann, T., et al. (2005). Die Resilienzskala—Ein Fragebogen zur Erfassung der psychischen Widerstandsfähigkeit als Personmerkmal. Z Klin Psychology Psychia,53, 16–39.

    Google Scholar 

  21. Meister, R. E., Weber, T., Princip, M., et al. (2015). Resilience as a correlate of acute stress disorder symptoms in patients with acute myocardial infarction. Open Heart,26(2), e000261.

    Article  Google Scholar 

  22. Meister, R. E., Princip, M., Schnyder, U., et al. (2016). Association of trait resilience with peritraumatic and posttraumatic stress in patients with myocardial infarction. Psychosomatic Medicine,78, 327–334.

    Article  Google Scholar 

  23. Morfeld, M., Kirchberger, I., & Bullinger, M. (2011). SF-36 Fragebogen zum Gesundheitszustand. Göttingen: Hogrefe.

    Google Scholar 

  24. Buckley, B., & Murphy, A. W. (2009). Do patients with angina alone have a more benign prognosis than patients with a history of acute myocardial infarction, revascularisation or both? Findings from a community cohort study. Heart,95, 461–467.

    Article  CAS  Google Scholar 

  25. Aboa-Éboulé, C., Brisson, C., Maunsell, E., et al. (2011). Effort-reward imbalance at work and recurrent coronary heart disease events: A 4-year prospective study of post-myocardial infarction patients. Psychosomatic Medicine,73, 436–447.

    Article  Google Scholar 

  26. Rosengren, A., Hawken, S., Ounpuu, S., et al. (2004). Association of psychosocial risk factors with risk of acute myocardial infarction in 11.119 cases and 13.648 controls from 52 countries (the INTERHEART study): Case–control study. Lancet,364, 953–962.

    Article  Google Scholar 

  27. Arnold, S., Smolderen, K., Buchanan, D., Li, Y., & Spertus, J. A. (2012). Perceived stress in myocardial infarction: Long-term mortality and health status outcomes. Journal of the American College of Cardiology,60, 1756–1763.

    Article  Google Scholar 

  28. Faul, F., Erdfelder, E., Buchner, A., & Lang, A. G. (2009). Statistical power analysis using G*Power 3.1: Tests for correlation and regression analyses. Behavior Research Methods,41, 1149–1160.

    Article  Google Scholar 

  29. VanderWeele, T. J., & Shpitser, I. (2011). A new criterion for confounder selection. Biometrics,67, 1406–1413.

    Article  Google Scholar 

  30. Chan, I. W. S., Lai, J. C. K., & Wong, K. W. N. (2006). Resilience is associated with better recovery in Chinese people diagnosed with coronary heart disease. Psychology Health,21, 335–349.

    Article  Google Scholar 

  31. Liu, C., Wang, L., & Zhao, Q. (2015). Factors related to health-related quality of life among Chinese psychiatrists: occupational stress and psychological capital. BMC Health Services Research,22(15), 20.

    Article  Google Scholar 

  32. Lossnitzer, N., Wagner, E., Wild, B., et al. (2014). Resilience in chronic heart failure. Deutsche Medizinische Wochenschrift,139, 580–584.

    Article  CAS  Google Scholar 

  33. Tian, J., & Hong, J. S. (2014). Assessment of the relationship between resilience and quality of life in patients with digestive cancer. World Journal of Gastroenterology,20, 18439–18444.

    Article  Google Scholar 

  34. Li, Y., Sun, X., Ge, H., Liu, J., & Chen, L. (2019). The status of occupational stress and 1st influence the quality of life of copper–nickel miners in Xinjiang, China. International Journal of Environmental Research and Public Health,16(3), e353.

    Article  Google Scholar 

  35. Barrech, A., Riedel, N., Li, J., et al. (2017). The long-term impact of a change in Effort-Reward imbalance on mental health-results from the prospective MAN-GO study. European Journal of Public Health,27, 1021–1026.

    Article  Google Scholar 

  36. Catalano, D., Chan, F., Wilson, L., Chiu, C. Y., & Muller, V. R. (2011). The buffering effect of resilience on depression among individuals with spinal cord injury: a structural equation model. Rehabilitation Psychology,56, 200–211.

    Article  Google Scholar 

  37. Wu, W. W., Tsai, S. Y., Liang, S. Y., Liu, C. Y., Jou, S. T., & Berry, D. L. (2015). The mediating role of resilience on quality of life and cancer symptom distress in adolescent patients with cancer. Journal of Pediatric Oncology Nursing,32, 304–313.

    Article  Google Scholar 

  38. Chmitorz, A., Kunzler, A., Helmreich, I., et al. (2018). Intervention studies to foster resilience—A systematic review and proposal for a resilience framework in future intervention studies. Clinical Psychology Review,59, 78–100.

    Article  CAS  Google Scholar 

  39. Cahill, M. C., Bilanovic, A., Kelly, S., Bacon, S., & Grace, S. L. (2015). Screening for depressionin cardiac rehabilitation: A review. Journal of Cardiopulmonary Rehabilitation & Prevention,35, 225–230.

    Article  Google Scholar 

  40. Huber, D., Hoerschelmann, N., Hoberg, E., Karoff, J., Karoff, M., & Kittel, J. (2014). Vocational inpatient and post-treatment proposals in cardiac rehabilitation patients (BERUNA): Results of a randomized controlled trial. Rehabilitation (Stuttg),53, 362–368.

    Article  CAS  Google Scholar 

  41. Jünger, C., Rauch, B., Schneider, S., et al. (2010). Effect of early short-term cardiac rehabilitation after acute ST-elevation and non-ST-elevation myocardial infarction on 1-year mortality. Current Medical Research and Opinion,26, 803–811.

    Article  Google Scholar 

Download references

Acknowledgements

The authors are grateful to the members of the MONICA/KORA Myocardial Infarction Registry Augsburg and the Helmholtz Zentrum München, Institute of Epidemiology, for their support. Moreover, we express our appreciation to all study participants.

Funding

This study was funded by the Deutsche Stiftung für Herzforschung (Grant No. F/22/13).

Author information

Authors and Affiliations

  1. Chair of Epidemiology, UNIKA-T Augsburg, Ludwig-Maximilians-Universität München, Neusässer Str. 47, 86156, Augsburg, Germany

    Inge Kirchberger & Christine Meisinger

  2. Central Hospital of Augsburg, MONICA/KORA Myocardial Infarction Registry, Augsburg, Germany

    Inge Kirchberger, Margit Heier & Christine Meisinger

  3. Centro de Investigación Biomédica en Red, Enfermedades Cardiovasculares (CIBERcv), Madrid, Spain

    Inge Kirchberger

  4. Department of Laboratory Medicine and Microbiology, University Hospital of Augsburg, Augsburg, Germany

    Katrin Burkhardt

  5. Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Institute of Epidemiology, Neuherberg, Germany

    Margit Heier

  6. Department of Internal Medicine I – Cardiology, University Hospital of Augsburg, Augsburg, Germany

    Christian Thilo

Authors
  1. Inge Kirchberger
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Katrin Burkhardt
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Margit Heier
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Christian Thilo
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Christine Meisinger
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Inge Kirchberger.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kirchberger, I., Burkhardt, K., Heier, M. et al. Resilience is strongly associated with health-related quality of life but does not buffer work-related stress in employed persons 1 year after acute myocardial infarction. Qual Life Res 29, 391–401 (2020). https://doi.org/10.1007/s11136-019-02306-6

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11136-019-02306-6

Keywords

Search

Navigation