Recovery following first myocardial infarction: An evaluation of the quality of life

Abstract

In the United Kingdom, Myocardial Infarction (MI) is the main cause of death in middle aged males but occurs amongst women later in their life. Whilst the death rate has halved overall, the incidence amongst women is increasing, especially in those who smoke. The majority of patients survive their first heart attack but little is known about their quality of life, or which factors may influence life quality, during the year following a first MI. This work aimed to (a) evaluate quality of life in both male and female patients during the year following a first myocardial infarction, (b)examine the influence of demographic (age, gender, hospital), clinical (infarct site, angina, intermittent claudication and possible subsequent myocardial infarction), and psychological variables (perceived mastery) on quality of life during the year following a myocardial infarction, and (c) evaluate the outcome of cardiac rehabilitation programmes in tenns of quality of life. One hundred and fifty-six patients (124 males and 32 females) who experienced their first MI and were admitted to the Royal Preston and Chorley Hospitals
and who gave their informed consent, were recruited into this longitudinal study. Patients were assessed on four occasions (two interviews and two postal questionnaires). Quality of Life (QoL) was measured using the SF-36 (Ware and Sherbourne, 1992) and perceived control was assessed with the Mastery Scale (Pearlin and Schooler, 1978).
Additional symptomatic cardiovascular illness was evaluated with the Rose Angina Questionnaire (Rose, McCartney and Reid, 1977). Quality of life was affected for post MI patients, even after one year, and those with the additional complications of angina and or intermittent claudication had the greatest decrements to their life quality. Age, gender and the hospital site had little impact on quality of life. Patients who had high mastery beliefs reported less deficit to their overall life quality than those with low perceived control. Attendance at the health education programme did not have a measurable affect upon patient's reported quality of life. On the contrary, non attendees evidenced less limitation in their physical abilities. Strategies which enhance perceived control may be more favourable to quality of life outcome for those who experience a myocardial infarction.