[Life quality of post-myocardial infarction patients: influence of personal variables on coping]

Coping in terms of physical, social, and psychological well-being and health-seeking behavior were studied by a self-reported questionnaire in 233 outpatients with myocardial infarction below 70 years of age. For most of these patients, physical limitations or discomfort were not significant, but the impacts on their emotion and social life were rather severe. As to social maladjustment, 70.3% of the patients were experiencing a deteriorated sexual life, 63.9% had not returned to their prior work status, 55.6% had decreased social participation and 45.7% had less interest in leisure activities. Physical morbidity was not the only determinant of maladaptation. Sex, educational level, existence of combined chronic disease, the time interval, and premorbid occupational characteristics all appear to be salient factors for coping. Those patients with a lower educational level were prone to the prominent threat of the disease (perceived lack of control and predictability), had higher scores of psychiatric symptoms, reported more physical symptoms, had a lower rate of work resumption and showed poorer medical compliance. Such data indicates that differences in disease-perception may be the mediators of socioenvironmental and illness-related influences. The rate of work resumption was also directly proportional to the patients' socioeconomic status and the degree of premorbid work responsibility and psychological demand reported by patients. Poorer outcomes of coping were also related to time interval since first heart attack and combined diabetes mellitus. Recovery from myocardial infarction is more than just a medical problem. Biomedical and psychosocial variables interact at many levels in the recovery process. It is of considerable practical importance to recognize the patients' coping ability, in order to obtain effective comprehensive care.