Sage Journals: Discover world-class research

Abstract

Background

Low marital quality is associated with adverse health outcomes and lower personal well-being. Loneliness increases the risk of cardiovascular disease and mortality and predicts poor quality of life. The aim of this study was to investigate the association between marital quality and loneliness and subjective health status in primary percutaneous coronary intervention (pPCI) patients who underwent cardiac rehabilitation (CR).

Design/methods

In a prospective cohort study, pPCI patients that followed CR were included between 2009–2011. A total of 223 patients responded to the Short Form 12 (SF-12) (subjective health status), Maudsley Marital Questionnaire (MMQ-6) (marital quality) and University of California, Los Angeles – Revised (UCLA-R) questionnaires at baseline (pre-CR) and at three months (post-CR) or at 12 months follow-up. Subjective health status is displayed by a physical component summary (PCS) score and a mental component summary (MCS) score. Generalized estimating equation (GEE) analyses were performed to test improvements in subjective health status.

Results

Changes over time in subjective health status scores were similar between patients with optimal marital quality vs patients with less optimal marital quality and non-lonely patients vs lonely patients. The MCS level at one-year follow-up of both patients with less optimal marital quality and lonely patients was lower compared with a healthy Dutch population (respectively; mean MCS score 47.3 (standard deviation (SD) 10.5); p = 0.013 and mean MCS score 46.1 (SD 11.2); p = 0.010).

Conclusion

Both patients with less optimal marital quality and lonely patients did not reach the MCS level of a healthy Dutch population. Therefore, extra care and support should be given to these patients in a CR programme.

Keywords

Percutaneous coronary intervention cardiac rehabilitation subjective health status marital quality loneliness

Get full access to this article

View all access options for this article.

References

GBD 2013 Mortality and Causes of Death Collaborators. Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death 1990-2013: A systematic analysis for the Global Burden of Disease Study 2013. Lancet 2015; 385: 117–171.

Sprangers

de Regt

Andries

. Which chronic conditions are associated with better or poorer quality of life? J Clin Epidemiol 2000; 53: 895–907.

Aarts

den Akker

Bosma

. The effect of multimorbidity on health related functioning: Temporary or persistent? Results from a longitudinal cohort study. J Psychosom Res 2012; 73: 211–217.

Wilson

D'Agostino

Levy

. Prediction of coronary heart disease using risk factor categories. Circulation 1998; 97: 1837–1847.

Kannel

Hjortland

Castelli

. Role of diabetes in congestive heart failure: The Framingham study. Am J Cardiol 1974; 34: 29–34.

Rosengren

Hawken

Ounpuu

. Association of psychosocial risk factors with risk of acute myocardial infarction in 11119 cases and 13648 controls from 52 countries (the INTERHEART study): Case-control study. Lancet 2004; 364: 953–962.

Pogosova

Saner

Pedersen

. Psychosocial aspects in cardiac rehabilitation: From theory to practice. A position paper from the Cardiac Rehabilitation Section of the European Association of Cardiovascular Prevention and Rehabilitation of the European Society of Cardiology. Eur J Prev Cardiol 2015; 22: 1290–1306.

Eaker

Sullivan

Kelly-Hayes

. Marital status, marital strain, and risk of coronary heart disease or total mortality the Framingham offspring study. Psychosom Med 2007; 69: 509–513.

King KB and Reis HT. Marriage and long-term survival after coronary artery bypass grafting. Health Psychol 2012; 31: 55–62.

10.

Proulx

Helms

Buehler

. Marital quality and personal well-being: A meta-analysis. J Marriage Fam 2007; 69: 576–593.

11.

Centraal Bureau voor de Statistiek. Huwelijksontbindingen; door echtscheiding en door overlijden, http://statline.cbs.nl/Statweb/publication/?VW=T&DM=SLNL&PA=37425ned&D1=a&D2=0,10,20,30,40,50,(l-1)-l&HD=150316-1159&HDR=G1&STB=T (2015, accessed 23 April 2015).

12.

Ekwall

Sivberg

Hallberg

. Loneliness as a predictor of quality of life among older caregivers. J Adv Nurs 2005; 49: 23–32.

13.

Patterson

Veenstra

. Loneliness and risk of mortality: A longitudinal investigation in Alameda County, California. Soc Sci Med 2010; 71: 181–186.

14.

Shiovitz-Ezra

Ayalon

. Situational versus chronic loneliness as risk factors for all-cause mortality. Int Psychogeriatr 2010; 22: 455–462.

15.

Perissinotto

Stijacic Cenzer

Covinsky

. Loneliness in older persons: A predictor of functional decline and death. Arch Intern Med 2012; 172: 1078–1083.

16.

Orathinkal

Vansteenwegen

Stroobants

. Further validation of the Maudsley Marital Questionnaire (MMQ). Psychol Health Med 2007; 12: 346–352.

17.

Russell

Peplau

Curtona

. The revised UCLA loneliness scale: Concurrent and discriminated validity. J Pers Soc Psychol 1980; 39: 472–480.

18.

Mols

Pelle

Kupper

. Normative data of the SF-12 health survey with validation using postmyocardial infarction patients in the Dutch population. Qual Life Res 2009; 18: 403–414.

19.

Gandek

Ware

Aaronson

. Cross-validation of item selection and scoring for the SF-12 Health Survey in nine countries: Results from the IQOLA Project. International Quality of Life Assessment. J Clin Epidemiol 1998; 51: 1171–1178.

20.

Perneger

Burnand

. A simple imputation algorithm reduced missing data in SF-12 health surveys. J Clin Epidemiol 2005; 58: 142–149.

21.

Twisk

. Longitudinal data analysis. A comparison between generalized estimating equations and random coefficient analysis. Eur J Epidemiol 2004; 19: 769–776.

22.

Bosworth

Siegler

Olsen

. Social support and quality of life in patients with coronary artery disease. Qual Life Res 2000; 9: 829–839.

23.

Staniute

Brozaitiene

Bunevicius

. Effects of social support and stressful life events on health-related quality of life in coronary artery disease patients. J Cardiovasc Nurs 2013; 28: 83–89.

24.

Murphy

Ludeman

Elliott

. Red flags for persistent or worsening anxiety and depression after an acute cardiac event: A 6-month longitudinal study in regional and rural Australia. Eur J Prev Cardiol 2014; 9: 1079–1089.

Supplementary Material

Please find the following supplemental material available below.

For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.

For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.

0.00 MB

0.01 MB

Marital quality and loneliness as predictors for subjective health status in cardiac rehabilitation patients following percutaneous coronary intervention