This repeated-measures study explores how self-efficacy and overprotection relate to psychological well-being, health-related quality of life and self-management. Eighty-two cardiac patients, suffering from congestive heart failure (CHF) or myocardial infarction (MI), completed questionnaires at T1 and three months later. Perceived overprotection is associated with concurrent levels of anxiety and depression, and lowered quality of life. Self-efficacy is related to psychological well-being in both patient groups, but only associated with quality of life in CHF patients. In addition, self-efficacy predicts MI patients' self-management behaviours in the medium term. Findings have implications for cardiac rehabilitation, where attention may usefully be focused on enhancing self-efficacy and dealing with issues of support and overprotection by the partner.
Bandura, A. (1986). Social foundations of thought and action. Englewood Cliffs, NJ: Prentice-Hall .
2.
Bandura, A. (1997). Self-efficacy: The exercise of control. New York: Freeman .
3.
Berkhuysen, M. A. , Nieuwland, W. , Buunk, B. P. , Sanderman, R. , & Rispens, P. (1999). Change in self-efficacy during cardiac rehabilitation and the role of perceived overprotectiveness .Patient Education and Counselling,38, 21–32 .
4.
Berkman, L. F. , Vaccarino, V. , & Seeman, T. (1993). Gender differences in cardiovascular morbidity and mortality: The contribution of social networks and support . Annals of Behavioral Medicine,15, 112–118 .
5.
Bjelland, I. , Dahl, A. A. , Tangen Haug, T. , & Neckelmann, D. (2002). The validity of the Hospital Anxiety and Depression Scale: An updated literature review . Journal of Psychosomatic Research,52, 69–77 .
6.
Bruhn, J. G. (1996). Social support and heart disease. In C. Cooper (Ed.),Handbook of stress, medicine and health(pp. 253–268). Boca Raton, FA: CRC Press .
7.
Burg, M. M. , & Seeman, T. E. (1994). Families and health: The negative side of social ties . Annals of Behavioral Medicine,16, 109–115 .
8.
Buunk, B. P. , Berkhuysen, M. A. , Sanderman, R. , Nieuwland, W. , & Ranchor, A. V. (1996). Actieve betrokkenheid, beschermend bufferen en overbescherming: Meetinstrument voor de rol van de partner bij hartrevalidatie . Gedrag en Gezondheid,24, 304–313 .
9.
Clark, N. M. , & Dodge, J. A. (1999). Exploring self-efficacy as a predictor of disease management . Health Education Behavior,26, 72–89 .
10.
Clarke, D. E. , Walker, J. R. , & Cuddy, E. (1996). The role of perceived overprotectiveness in recovery 3 months after myocardial infarction .Journal of Cardiopulmonary Rehabilitation,16, 372–377 .
11.
Cowie, M. R. , Mosterd, A. , Wood, D. A. , Deckers, J. W. , Poole-Wilson, P. A. , Sutton, G. C. , & Grobbee, D. E. (1997). The epidemiology of heart failure . European Heart Journal,18, 208–225 .
12.
Coyne, J. C. , & DeLongis,A. (1986). Going beyond social support: The role of social relationships in adaptation . Journal of Consulting and Clinical Psychology,54, 454–460 .
13.
Coyne, J. C. , Ellard, J. H. , & Smith, D. A. F. (1990). Social support, interdependence, and the dilemmas of helping. In B. R. Sarason , I. G. Sarason , & G. R. Pierce (Eds.), Social support: An interactional view (pp. 129–149). New York: John Wiley .
14.
Coyne, J. C. , & Smith, D. A. (1991). Couples coping with myocardial infarction: A contextual perspective on wives' distress . Journal of Personality and Social Psychology, 61, 404–412 .
15.
Coyne, J. C. , & Smith, D. A. (1994). Couples coping with myocardial infarction: Contextual perspective on patient self-efficacy . Journal of Family Psychology,8, 43–54 .
16.
Cutrona, C. E. (1996). Social support in couples. Thousand Oaks, CA: Sage .
17.
De Gucht, V. , van Elderen, T. M. T. , van der Kamp, L. , & Oldridge, N. (2003). Quality of life after myocardial infarction: Translation and validation of the MacNew for a Dutch population. Submitted for publication.
18.
Dracup, K. (1994). Cardiac rehabilitation: The role of social support in recovery and compliance. In S. A. Shumaker & S. M. Czajkowski (Eds.),Social support and cardiovascular disease (pp. 333–353). New York: Plenum Press .
19.
Dracup, K. , Walden, J. A. , Stevenson, L. W. , & Brecht, M. (1992). Quality of life in patients with advanced heart failure . Journal of Heart & Lung Transplantation,11, 273–279 .
20.
Eiser, J. R. , Riazi, A. , Eiser, C. , Hammersley, S. , & Tooke, J. E. (2001). Predictors of psychological well-being in types 1 and 2 diabetes . Psychology and Health,16, 99–110 .
21.
Ewart, C. K. (1992). Role of physical self-efficacy in recovery from heart attack. In R. Schwarzer (Ed.), Self-efficacy: Thought control of action(pp. 287–304). Bristol: Taylor Francis .
22.
Fiske, V. , Coyne, J. C. , & Smith, D. A. (1991). Couples coping with myocardial infarction: An empirical reconsideration of the role of overprotectiveness . Journal of Family Psychology,5, 4–20 .
23.
Frasure-Smith, N. , Lespérance, F. , & Talajic, M. (2000). The prognostic importance of depression, anxiety, anger, and social support following myocardial infarction: Opportunities for improving survival. In P. M. McGabe , N. Schneiderman , T. Field , & A. R. Wellens (Eds.),Stress, coping, and cardiovascular disease (pp. 203–228). Mahwah, NJ: Lawrence Erlbaum Associates .
24.
Freedland, K. E. , Rich, M. W. , Skala, J. A. , Carney, R. M. , Dávila-Román, V. G. , & Jaffe, A. S. (2003). Prevalence of depression in hospitalised patients with congestive heart failure . Psychosomatic Medicine,65, 119–128 .
25.
Friedman, M. M. (1993). Social support sources and psychological well-being in older women with heart disease . Research in Nursing and Health,16, 405–413 .
26.
Gallant, M. P. (2003). The influence of social support on chronic illness self-management: A review and directions for research . Health, Education and Behavior,30, 170–195 .
27.
Gilroy, M. B. R. (1990). Multiple factors affect dieticians counselling practices for high blood cholesterol . Journal of the American Dietetic Association,94, 1278–1283 .
28.
Grigioni, F. , Carigi, S. , Grandi, S. , Potena, L. , Coccolo, F. , Bacchi-Reggiani, L. et al. (2003). Distance between patients' subjective perceptions and objective evaluated disease severity in chronic heart failure . Psychotherapy and Psychosomatics,72, 166–170 .
29.
Hillers, T. K. , Guyatt, G. H. , Oldridge, N. , Crowe, J. , Willan, A. , Griffith, L. , & Freeny, D. (1994). Quality of life after myocardial infarction . Journal of Clinical Epidemiology,47, 1287–1296 .
30.
Itkowitz, N. I. , Kerns, R. D. , & Otis, J. D. (2003). Support and coronary heart disease: The importance of significant other responses . Journal of Behavioral Medicine,26, 19–30 .
31.
Jaarsma, T. , Halfens, R. , Huijer Abu-Saad, H. , Dracup, K. , Stappers, J. , & van Ree, J. (1999). Quality of life in older patients with systolic and diastolic heart failure . European Journal of Heart Failure,1, 151–160 .
32.
Kuijer, R. G. , & de Ridder, D. T. D. (2003). Discrepancy in illness-related goals and quality of life in chronically ill patients: The role of self-efficacy . Psychology & Health, 18, 313–330 .
33.
Lane, D. , Carroll, D. , Ring, C. , Beevers, D. G. , & Lip, G. Y. H. (2002). The prevalence and persistence of depression and anxiety following myocardial infarction . British Journal of Health Psychology,7, 11–21 .
34.
Lorig, K. , & González, V. (1992). The integration of theory with practice: A 12-year case study . Health Education Quarterly,19, 355–368 .
35.
Lorig, K. , Stewart, A. , Ritter, P. , González, V. , Laurent, D. , & Lynch, J. (1996). Outcome measures for health education and other health care measures. Thousand Oaks, CA: Sage .
36.
Maddux, J. E. , & Meier, L. J. (1995). Self efficacy and depression. In J. E. Maddux (Ed.),Self-efficacy, adaptation, and adjustment: Theory, research, and application (pp. 143–169). New York: Plenum Press .
37.
Mendes de Leon, C. F. , Krumholz, H. M. , Vaccarino, V. , Williams, C. S. , Glass, T. A. , Berkman, L. F. , & Kasl, S.V. (1998). A population-based perspective of changes in health-related quality of life after myocardial infarction in older men and women . Journal of Clinical Epidemiology,51, 609–616 .
38.
Moser, D. K. (1997). Heart failure in women . Critical Care Nursing Clinics of North America,9, 511–519 .
39.
Murberg, T. A. , Bru, E. , Aarsland, T. , & Svebak, S. (1998). Social support, social disability and their role as predictor of depression among patients with congestive heart failure . Scandinavian Journal of Social Medicine,26, 87–95 .
40.
Netherlands Heart Foundation . (2002). Multidisciplinaire richtlijn: Chronisch hartfalen[Multidisciplinary guidelines: Chronic heart failure]. Nederlandse Hartstichting & Nederlandse Vereniging Voor Cardiologie. Alphen a/d Rijn, NL: Van Zuiden .
41.
Oldridge, N. , Gottlieb, M. , Guyatt, G. H. , Jones, N. , Streiner, D. , & Feeny, D. (1998). Predictors of healthrelated quality of life with cardiac rehabilitation after acute myocardial infarction . Journal of Cardiopulmonary Rehabilitation,18, 95–103 .
42.
Oldridge, N. B. , & Rogowski, B. L. (1990). Self-efficacy and in-patient rehabilitation . American Journal of Cardiology, 66, 362–365 .
43.
Orth-Gomer, K. (2000). Stress and social support in relation to cardiovascular health. In P. M. McGabe , N. Schneiderman , T. Field , & A. R. Wellens (Eds.), Stress, coping and cardiovascular disease (pp. 229–240). Mahwah, NJ: Lawrence Erlbaum Associates .
44.
Plevier, C. M. , Mooy, J. M. , Marang-Van de Mheen, P. J. , Stouthard, M. E. A. , Visser, M. C. , Grobbee, D. E. , & Gunning-Schepers, L. J. (2001). Persistent impaired emotional functioning in survivors of a myocardial infarction . Quality of Life Research,10, 123–132 .
45.
Rand, C. S. (2000). ‘I took the medication like you told me, doctor’: Self-report of adherence with medical regimen. In A. A. Stone , J. S. Turkan , C. A. Bachrach , J. B. Jober , H. S. Kurtzman , & V. S. Cain (Eds.),The science of self-report: Implications for research and practice (pp. 257–276). Mahwah, NJ: Lawrence Erlbaum Associates .
46.
Riegel, B. , & Dracup, K. (1992). Does overprotection cause cardiac invalidism after acute myocardial infarction?Heart & Lung,21, 529–535 .
47.
Robertson, D. , & Keller, C. (1992). Relationships among health beliefs, self-efficacy, and exercise adherence in patients with coronary artery disease . Heart & Lung, 21, 56–63 .
48.
Romano, J. M. , Turner, J. A. , Jensen, M. P. , Friedman, L. S. , Bulcroft, R. A. , Hops, H. et al. (1995). Chronic pain patient–spouse behavioral interactions predict patient disability . Pain,63, 353–360 .
49.
Rook, K. S. (1992). Detrimental aspects of social relationships: Taking stock of an emerging literature. In H. O. F. Veiel & U. Baumann (Eds.),The meaning and measurement of social support (pp. 157–169). New York: Hemisphere Publishing Corporation .
50.
Rose, G. L. , Suls, J. , Green, P. J. , Lounsbury, P. , & Gordon, E. (1996). Comparison of adjustment, activity, and tangible social support in men and women patients and their spouses during the six months post-myocardial infarction . Annals of Behavioral Medicine,18, 264–272 .
51.
Rowland, J. H. (1990). Interpersonal resources: Social support. In J. C. Holland & J. H. Howland (Eds.), Handbook of psychooncology (pp. 58–71). New York: Oxford University Press .
52.
Sarason, I. G. , Sarason, B. R. , & Pierce, G. R. (1994). Relationship specific social support: Towards a model for the analysis of supportive interactions. In B. R. Burleson , T. L. Albrecht , & I. G. Sarason (Eds.), Communication of social support: Messages, interactions, relationships, and community (pp. 91–112). Thousand Oaks, CA: Sage .
53.
Schmaling, K. B. , Smith, W. R. , & Buchwald, D. S. (2000). Significant other responses are associated with fatigue and functional status among patients with chronic fatigue syndrome . Psychosomatic Medicine,62, 444–450 .
54.
Skotzko, C. E. , Krichten, C. , Zietowksi, G. , Alves, L. , Freudenberger, R. , Robinson, S. et al. (2000). Depression is common and precludes accurate assessment of functional status in elderly patients with congestive heart failure . Journal of Cardiac Failure,6, 300–305 .
55.
SOLVD Investigators . (1990). Studies of Left Ventricular Dysfunction (SOLVD)—rationale, design and methods: Two trials that evaluate the effect of enalapril in patients with reduced ejection fraction . American Journal of Cardiology,66, 315–322 .
56.
Spinhoven, P. , Ormel, J. , Sloekers, P. P. A. , Kempen, G. I. J. M. , Speckens, A. E. M. , & van Hemert, A. M. (1997). A validation study of the Hospital Anxiety and Depression Scale (HADS) in different groups of Dutch subjects . Psychological Medicine,27, 363–370 .
57.
Sullivan, M. D. , LaCroix, A. Z. , Russo, J. , & Katon, W. J. (1998). Self-efficacy and self-reported functional status in coronary heart disease: A six-month prospective study . Psychosomatic Medicine,60, 473–478 .
58.
Thompson, S. C. , & Sobolew-Shubin, A. (1993). Overprotective relationships: A nonsupportive side of social networks . Basic and Applied Social Psychology, 14, 363–383 .
59.
Turk, D. C. , Kerns, R. D. , & Rosenberg, R. (1992). Effects of marital interaction on chronic pain and disability: Examining the down-side of social support . Rehabilitation Psychology,37, 259–274 .
60.
Valenti, L. , Lim, L. , Heller, R. F. , & Knapp, J. (1996). An improved questionnaire for assessing quality of life after acute myocardial infarction . Quality of Life Research,5, 151–161 .
61.
WHO . (2002). World Health Organization website, http://www.who.int
62.
Wicklund, I. , Sanne, H. , Vedin, A. , & Wilhelmsson, C. (1984). Sick-role and attitude towards disease and working life two months after myocardial infarction . Scandinavian Journal of Rehabilitation Medicine,16, 57–64 .
63.
Zigmond, A. S. , & Snaith, R. P. (1983). The Hospital Anxiety and Depression Scale . Acta Psychiatrica Scandinavica,67, 361–370 .
