Rehabilitation after coronary bypass surgery: coping strategies predict metabolic improvement and return to work

Thirty-six consecutive male patients who underwent coronary bypass surgery were investigated before and repeatedly up to 5 years after surgery. We followed the patients' physical capacity, dietary and exercise habits, mood, perception of health and return to work. Discriminant analysis identified four variables from the preoperative interview and the psychological tests which correctly classified 22 out of 24 patients into either metabolic responders--who were characterized by favourable changes in their lipoprotein profile, related to a successful clinical outcome--or non-responders. Responders were found to acknowledge subjective, emotional aspects of their situation whereas non-responders minimised their disease. Six preoperative variables successfully predicted the classification of all but one patient into full-time workers or not, one year after surgery. Full-time workers were more frequent among minimizers. The results suggest that whereas minimising of disease is adaptive in a short-term perspective, acknowledgement may be successful in the long run.