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Health-Related Quality of Life is Associated with Positive Affect in Patients with Coronary Heart Disease Entering Cardiac Rehabilitation

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Abstract

Health-related quality of life (QoL) is an important and widely used outcome measure in cardiac populations. We examined the relationship between positive affect and health-related quality of life, controlling for traditional cardiovascular risk factors, clinical variables and negative affect. We further investigated the role of gender in this relationship given the well-known gender differences in cardiovascular health. We enrolled 746 patients with coronary heart disease (CHD) before they entered outpatient cardiac rehabilitation. All patients completed the Global Mood Scale and the SF-36 Health Survey. Positive affect was independently associated with mental (p < .001) and physical QoL (p < .001) after controlling for control variables. Gender moderated the relationship between positive affect and physical QoL (p = .009) but not mental QoL (p = .60). Positive affect was positively associated with physical QoL in men (p < .001) but not in women (p = .44). The health-related QoL of patients with CHD is associated with a person’s level of positive affect.

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References

  • Alvarado, G. F., & Breslau, N. (2005). Smoking and young people’s mental health. Current Opinion in Psychiatry, 18, 397–400.

    Article  PubMed  Google Scholar 

  • Baron, R. M., & Kenny, D. A. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51, 1173–1182.

    Article  PubMed  CAS  Google Scholar 

  • Barth, J., Schumacher, M., & Herrmann-Lingen, C. (2004). Depression as a risk factor for mortality in patients with coronary heart disease: A meta-analysis. Psychosomatic Medicine, 66, 802–813. doi:10.1097/01.psy.0000146332.53619.b2.

    Article  PubMed  Google Scholar 

  • Barth, J., Volz, A., Schmid, J., Kohls, S., von Känel, R., Znoj, H., & Saner, H. (2009). Gender differences in cardiac rehabilitation outcomes: Do women benefit equally in psychological health? Journal of Women’s Health, 18, 2033–2039. doi:10.1089=jwh.2008.1058.

    Google Scholar 

  • Beck, C. A., Joseph, L., Bélisle, P., & Pilote, L. (2001). Predictors of quality of life 6 month and 1 year after myocardial infarction. American Heart Journal, 142, 271–279. doi:10.1067/mhj.2001.116758.

    Article  PubMed  CAS  Google Scholar 

  • Bjarnason-Wehrens, B., Grande, G., Loewel, H., Völler, H., & Mittag, O. (2007). Gender specific issues in cardiac rehabilitation: Do women with ischaemic heart disease need specially tailored programmes? European Journal of Cardiovascular Prevention and Rehabilitation, 14, 163–171. doi:10.1097/HJR.0b013e3280128bce.

    Article  PubMed  Google Scholar 

  • Brummett, B. H., Boyle, S. H., Siegler, I. C., Williams, R. B., Mark, D. B., & Barefoot, J. C. (2005). Ratings of positive and depressive emotion as predictors of mortality in coronary Patients. International Journal of Cardiology, 100, 213–216. doi:10.1016/j.ijcard.2004.06.016.

    Article  PubMed  Google Scholar 

  • Bullinger, M., Alonso, J., Aplone, G., Leplège, A., Sullivan, M., Wood-Dauphinee, S., et al. (1998). Translating health status questionnaires and evaluating their quality: The IQOLA project approach. Journal of Clinical Epidemiology, 51, 913–923.

    Google Scholar 

  • Chida, Y., & Steptoe, A. (2008). Positive psychological well-being and mortality: A quantitative review of prospective observational studies. Psychosomatic Medicine, 70, 741–756. doi:10.1097/PSY.0b013e31818105ba.

    Article  PubMed  Google Scholar 

  • Chida, Y., & Steptoe, A. (2009). The association of anger and hostility with future coronary heart disease: A meta-analytic review of prospective evidence. Journal of the American College of Cardiology, 53, 936–946. doi:10.1016/j.jacc.2008.11.044.

    Article  PubMed  Google Scholar 

  • Coyne, K. S., Lundergan, C. F., Boyle, D., Greenhouse, S. W., Draoui, Y. C., Walker, P., & Ross, A. M. (2000). Relationship of infarct artery patency and left ventricular ejection fraction to health-related quality of life after myocardial infarction: The Gusto-I angiographic study experience. Circulation, 102, 1245–1251.

    Google Scholar 

  • Crilley, J. G., & Farrer, M. (2001). Impact of first myocardial infarction on self-perceived health status. Quarterly Journal of Medicine, 94, 13–18.

    Article  CAS  Google Scholar 

  • Denollet, J. (1993). Emotional distress and fatigue in coronary disease: The global mood scale (GMS). Psychological Medicine, 23, 111–121.

    Article  PubMed  CAS  Google Scholar 

  • Denollet, J., Schiffer, A. A., & Spek, V. (2010). A general propensity to psychological distress affects cardiovascular outcomes: Evidence from research on the type D (distressed) personality profile. Circulation: Cardiovascular Quality and Outcomes, 3, 546–557. doi:10.1161/CIRCOUTCOMES.109.934406.

    Google Scholar 

  • Denvir, M. A., Lee, A. J., Rysdale, J., Walker, A., Eteiba, H., Starkey, I. R., & Pell, J. P. (2006). Influence of socioeconomic status on clinical outcomes and quality of life after percutaneous coronary intervention. Journal of Epidemiology and Community Health, 60, 1085–1088. doi:10.1136/jech.2005.044255.

    Google Scholar 

  • Di Bonaventura M., Poulose-Ram R., Su, J., McDonald, M., Zou, K., Wagner, J., & Shah, H. (2012). The impact of COPD on quality of life, productivity loss, and resource use among the elderly united states workface. COPD, 9, 46–57. doi:10.3109/15412555.2011.634863.

  • Do, C. B., & Batzoglou, S. (2008). What is the expectation maximization algorithm? Nature Biotechnology, 8, 897–899.

    Article  Google Scholar 

  • Ellert, U., & Kurth, B. M. (2004). Methodische Betrachtungen zu den Summenscores des SF-36 anhand der erwachsenen bundesdeutschen Bevölkerung. Bundesgesundheitsblatt – Gesundheitsforschung – Gesundheitsschutz, 47, 1027–1032. doi:10.1007/s00103-004-0933-1.

  • Emery, C. F., Frid, D. J., Engebretson, T. O., Alonzo, A. A., Fish, A., Ferketich, A. K., et al. (2004). Gender differences in quality of life among cardiac patients. Psychosomatic medicine, 66, 190–197. doi:10.1097/01.psy.0000116775.98593.f4.

  • Enders, C. A. (2006). A primer on the use of modern missing-data methods in psychosomatic medicine research. Psychosomatic Medicine, 68, 427–436. doi:10.1097/01.psy.0000221275.75056.d8.

    Article  PubMed  Google Scholar 

  • Ernst, J., Götze, H., Brähler, E., Körner, A., & Hinz, A. (2012). Quality of life of parents diagnosed with cancer: Change over time and influencing factors. European Journal of Cancer Care. doi:10.1111/j.1365-2354.2012.01330.

    PubMed  Google Scholar 

  • Fava, G. A., & Tomba, E. (2009). Increasing psychological well-being and resilience by psychotherapeutic methods. Journal of Personality, 77, 1903–1934. doi:10.1111/j.1467-6494.2009.00604.x.

    Article  PubMed  Google Scholar 

  • Fortin, M., Dubois, M., Hudon, C., Soubhi, H., & Almirall, J. (2007). Multimorbidity and quality of life: A closer look. Health and Quality of Life Outcomes, 5(52). Retrieved from http://www.hqlo.com/content/5/1/52.

  • Freedland, K. E., Carney, R. M., & Skala, J. A. (2005). Depression and smoking in coronary heart disease. Psychosomatic Medicine, 67, 42–46. doi:10.1097/01.psy.0000162255.55629.9c.

    Article  Google Scholar 

  • Garavalia, L. S., Decker, C., Reid, K. J., Lichtman, J. H., Parashar, S., Vaccarino, V., et al. (2007). Does health status differ between men and women in early recovery after myocardial infarction? Journal of Women’s Health, 16, 93–101. doi:10.1089/jwh.2006.M073.

    Google Scholar 

  • Grande, G., & Romppel, M. (2011). Gender differences in recovery goals in patients after acute myocardial infarction. Journal of Cardiopulmonary Rehabilitation and Prevention, 31, 164–172. doi:10.1097/HCR.0b013e31820333c8.

    PubMed  Google Scholar 

  • Hevey, D., Mc Gee, H. M., & Horgan, J. (2004). Responsiveness of health-related quality of life outcome measures in cardiac rehabilitation: Comparison of cardiac rehabilitation outcome measures. Journal of Consulting and Clinical Psychology, 6, 1175–1180. doi:10.1037/0022-006X.72.6.1175.

    Article  Google Scholar 

  • Höfer, S., Benzer, W., Alber, H., Ruttmann, E., Kopp, M., Schüssler, G., & Doering, S. (2005). Determinants of health-related quality of life in coronary artery disease patients: A prospective study generating a structural equation model. Psychosomatics, 46, 212–223.

  • Jain, S., Shapiro S. L., Swanick, S., Roesch, S. C., Mills, P. J., Bell, I., & Schwartz, G. E. R. (2007). A randomized controlled trial of mindfulness versus relaxation training: Effect on distress, positive state of mind, rumination, and distraction. Annals of Behavioral Medicine, 33, 11–21.

    Google Scholar 

  • Kuppens, P., Realo, A., & Diener, E. (2008). The role of positive and negative emotions in life satisfaction judgement across nations. Journal of Personality and Social Psychology, 95, 66–75. doi:10.1037/0022-3514.95.1.66.

    Article  PubMed  Google Scholar 

  • Marinho, V., Blay, S. L., Andreoli, S. B., & Gastal, F. (2008). A prevalence study on current tobacco smoking in later life community and it’s association with sociodemographic factors, physical health and mental health status. Social Psychiatry and Psychiatric Epidemiology, 43, 490–497. doi:10.1007/s00127-008-0338-9.

    Article  PubMed  Google Scholar 

  • Melamed, S., Shirom, A., Toker, S., Berliner, S., & Shapira, I. (2006). Burnout and risk of cardiovascular disease: Evidence, possible causal paths, and promising research directions. Psychological Bulletin, 132, 327–353. doi:10.1037/0033-2909.132.3.327.

    Article  PubMed  Google Scholar 

  • Mommersteeg, P. M. C., Denollet, J., Spertus, J. A., & Pedersen, S. S. (2009). Health status as a risk factor in cardiovascular disease: A systematic review of current evidence. American Heart Journal, 157, 208–218. doi:10.1016/j.ahj.2008.09.020.

    Article  PubMed  Google Scholar 

  • Mortensen, O. S., Bjorner, J. B., Newman, B., Oldenburg, B., Groenvold, M., Madsen, J. K., & Andersen, H. (2007). Gender differences in health-related quality of life following ST-elevation myocardial infarction: Women and men do not benefit from primary percutaneous coronary intervention to the same degree. European Journal of Cardiovascular Prevention and Rehabilitation, 14, 37–43. doi:10.1097/HJR.0b013e3280114f00.

    Google Scholar 

  • Pettersen, K. I., Kvan, E., Rollag, A., Stavem, K., & Reikvam, A. (2008). Health-related quality of life after myocardial infarction with level of left ventricular ejection fraction. BMC Cardiovascular disorders, 8, 28. doi:10.1186/1471-2261-8-28.

    Article  PubMed  Google Scholar 

  • Roest, A. M., Martens, E. J., Denollet, J., & de Jonge, P. (2010). Prognostic association of anxiety postmyocardial infarction with mortality and new cardiac events: A meta-analysis. Psychosomatic Medicine, 72, 563–569. doi:10.1097/PSY.0b013e3181dbff97.

    Article  PubMed  Google Scholar 

  • Ross, C. E., & Wu, C. (1995). The links between education and health. American Sociological Review, 60, 719–745.

    Article  Google Scholar 

  • Rumsfeld, J. S., MaWhinney, S., McCarthy, M., Shroyer, A. L. W., VillaNueva, C. B., O’Brien, M., et al. (1999). Health-related quality of life as a predictor of mortality following coronary artery bypass graft surgery. JAMA, 281, 1298–1303.

    Google Scholar 

  • Sin, N. L., & Lyubomirsky, S. (2009). Enhancing well-being and alleviating depressive symptoms with positive psychology interventions: A practice friendly meta-analysis. Journal of Clinical Psychology, 65, 467–487. doi:10.1002/jclp.20593.

    Article  PubMed  Google Scholar 

  • Smith, T. W. (2011). Toward a more systematic, cumulative, and applicable science of personality and health: Lessons from type D personality. Psychosomatic Medicine, 73, 528–532. doi:10.1097/PSY.0b013e31822e095e.

    Article  PubMed  Google Scholar 

  • Spertus, J. A., Jones, P., McDonell, M., Fan, V., & Fihn, S. D. (2002). Health status predicts long-term outcome in outpatients with coronary disease. Circulation, 106, 43–49. doi:10.1161/01.CIR.0000020688.24874.90.

    Article  PubMed  Google Scholar 

  • Spindler, H., Denollet, J., Kruse, C., & Pedersen, S. (2009). Positive affect and negative affect correlate differently with distress and health-related quality of life in patients with cardiac conditions: Validation of the Danish Global Mood Scale. Journal of Psychosomatic Research, 67, 57–65. doi:10.1016/j.jpsychores.2008.11.003.

    Article  PubMed  Google Scholar 

  • Steptoe, A., Dockray, S., & Wardle, J. (2009). Positive affect and psychobiological processes relevant to health. Journal of Personality, 77, 1747–1776. doi:10.1111/j.1467-6494.2009.00599.x.

    Article  PubMed  Google Scholar 

  • Sullivan, M. D., LaCroix, A., Russo, J. E., & Walker, E. A. (2001). Depression and self-reported physical health in patients with coronary disease: Mediating and moderating effects. Psychosomatic Medicine, 63, 248–256.

    PubMed  CAS  Google Scholar 

  • Versteeg, H., Pedersen, S. S., Erdman, R. A. M., van Nierop, J. W. I., de Jaegere, P., & van Domburg, R. T. (2009). Negative and positive affect are independently associated with patient reported health status following percutaneous coronary intervention. Quality of Life Research, 18, 953–960. doi:10.1007/s11136-009-9511-1.

    Article  PubMed  Google Scholar 

  • Ware, J. E., & Gandek, B. (1998). Overview of the SF-36 health survey and the International Quality of Life Assessment (IQOLA) project. Journal of Clinical Epidemiology, 51, 903–912.

    Article  PubMed  Google Scholar 

  • Ware, J. E., & Sherbourne, C. D. (1992). The MOS 36-item Short Form Health Survey (SF-36). I. Conceptual framework and item selection. Medical Care, 30, 473–483.

    Article  PubMed  Google Scholar 

  • Watson, D., & Pennebaker, J. W. (1989). Health complaints, stress, and distress: Exploring the central role of negative affectivity. Psychological Review, 96, 234–254.

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of General Internal Medicine, Division of Psychosomatic Medicine, Inselspital, Bern University Hospital, 3010, Bern, Switzerland

    Stefanie Stauber & Roland von Känel

  2. University of Bern, Bern, Switzerland

    Stefanie Stauber, Jean-Paul Schmid, Hugo Saner, Gaby Saner, Johannes Grolimund & Roland von Känel

  3. Cardiovascular Prevention and Rehabilitation, Swiss Cardiovascular Centre, Inselspital, Bern University Hospital, Bern, Switzerland

    Jean-Paul Schmid, Hugo Saner, Gaby Saner, Johannes Grolimund & Roland von Känel

  4. Clinical Psychology and Psychotherapy, University of Bern, Bern, Switzerland

    Hansjörg Znoj

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  1. Stefanie Stauber
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  2. Jean-Paul Schmid
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  3. Hugo Saner
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  4. Hansjörg Znoj
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Correspondence to Stefanie Stauber.

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Stauber, S., Schmid, JP., Saner, H. et al. Health-Related Quality of Life is Associated with Positive Affect in Patients with Coronary Heart Disease Entering Cardiac Rehabilitation. J Clin Psychol Med Settings 20, 79–87 (2013). https://doi.org/10.1007/s10880-012-9311-6

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