Coping in post-myocardial infarction patients and spouses/companions at risk for sudden cardiac death

Abstract

Families use coping to restore stability after introduction of an acute stressor. Depression and anxiety influence patient coping in post-MI patients and their spouse/companion. The Resiliency Model of Family Stress, Adjustment, and Adaptation explains how family type, severity of illness, prior stressors, resources, and psychological status predict coping. This study examined the contributions of these factors to coping in post-MI patients and their spouses/companions during acute stress. The "The Patients' and Families' Psychological Response to Home Automatic Defibrillator Trial (PRHAT)" surveyed 462 post-MI patients and their spouses/companions participating in a study of home defibrillators. Data included scores on the Family Crisis Oriented Personal Evaluation Scales (F-COPES), Beck Depression Inventory-II (BDI-II), and State-Trait Anxiety Inventory (STAI). Hypotheses were tested with correlations, multiple regressions, and hierarchical regressions.;Depression (15.5 spouse/companion-20.2% patient) and anxiety (19.1 spouse/companion-25.6% patient) were common in study participants. Family type was a significant predictor of patient (R2=.037, p=.001) and spouse/companion (R2=.077, p=.001) coping (total F-COPES). Patients' coping predicted spouses/companions' coping (p<.01) after controlling for the contributions of spouse/companion and patient age, gender, education, and employment; and the mediating or moderating effects of spouse/companion anxiety, depression, and resources. Patient state anxiety mediated the relationships between patient family type and severity of illness, and coping. Patient anxiety and depression moderated the relationships of patient family type and illness severity to coping. Spouse/companion psychological status mediated and moderated the relationships of family type and prior stressors to spouse/companion coping. Higher depression and anxiety were related to poorer coping in both groups.;Family type and psychological status predicted coping in post-MI patients and their spouses/companions during a period of stress. Interventions to reduce stress and anxiety may improve coping ability of post MI patients and their families.