The Combined Effect of Psychological and Relational Aspects on Cardiac Patient Activation

The literature assumes that activating patients in the treatment is associated with positive health-related outcomes, such as clinical indicators in the normal range, high medication adherence, and low emergency department utilization. In the cardiac population, patient activation, that is the patient's knowledge, skills, confidence, and behaviors needed for managing one's own health and health care, has been less investigated. In addition, limited attention has been given to the role of the partner as an informal caregiver. However, the patient in the care process is rarely alone, and the partner may play a key role in this process. The goal of this dyadic study (N = 100 heterosexual couples with one partner suffering from an acute cardiac event) is to analyze how individual factors (patients' anxiety, depression, medication adherence, pessimistic perception of illness) and the couple's relationship functioning (e.g., different kinds of partner support and dyadic coping) are associated with patient activation. The results showed that patient activation is not a mere question of age. It is positively related to medication adherence and to the partner's support patient activation. It is negatively correlated with the patient's psychological distress, pessimistic perception of illness, and to the partner's hostility. The need for a dyadic approach to both research and intervention with this population is discussed.