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.

Job strain is associated with a heightened blood pressure response to uncontrollable but not controllable tasks. The failure of subjects with high job strain to show reduced blood pressure in the evening may be a manifestation of chronic allostatic load.

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Aim of this cross-sectional study, was to examine whether the sudden event of hospitalization for Myocardial Infarction (MI) would lead to a disturbance in the attainment of important higher order or life goals, and secondly, whether goal importance as well as goal disturbance would be related to emotional distress and health-related quality of life (HRQL) shortly (two to five weeks) after the MI. Respondents were 160 patients who were hospitalized for MI. Results indicate that patients experience goal disturbance as a result of their cardiac event. Hierarchical regression analyses showed that independently from demographics, medical characteristics and prior lifestyle, disturbance of important higher order goals was a powerful correlate of anxiety, depression as well as HRQL. Furthermore, the extent to which patients valued higher order goals in their life (goal importance) was an independent correlate of depression. Based on self-regulation theory, we suggest that emotional distress and lower levels of HRQL can be explained in terms of threat to goal attainment. Recommendations for further research and practical implications for rehabilitation programs were formulated.

Job strain is associated with psychiatric morbidity. The high levels of neurotic psychopathology among teachers is consistent with previous research that has found teaching to be a highly stressful occupation.

OBJECTIVE: To assess the in¯uence of abdominal obesity and work stress (operationalised as low control over work) on ambulatory blood pressure on a working day and evening. PARTICIPANTS AND METHODS: 156 school teachers (58 men and 98 women) carried out ambulatory blood pressure and heart rate monitoring on a work day and evening. Cardiovascular activity was also measured under baseline conditions on another occasion, when body weight, height, waist and hip circumference were assessed. Perceived control over work was assessed by questionnaire, along with mental health, anger expression and social support. 126 participants repeated the protocol after 12 months. Waistahip ratio was used as the index of abdominal obesity. RESULTS: Baseline blood pressure was positively associated with waistahip ratio in men, but ambulatory blood pressure and heart rate were not independently related to waistahip ratio or job control. However, blood pressure and heart rate recorded during the working day and evening were elevated in men with high waistahip ratio who experienced low job control, independently of age and body weight. Effects for diastolic blood pressure and heart rate were replicated after 12 months. Body mass index was not related to blood pressure or heart rate during the day or evening after adjustment for age and waist circumference. Low job control was associated with poor psychological well-being, negative mood and lack of social support. CONCLUSIONS: The results are consistent with the hypothesis that abdominal obesity in men is characterised by a tendency towards heightened stress-induced physiological activation, but that this tendency will only be manifest in the presence of appropriate environmental challenges such as chronic work stress.