Optimism and Rehospitalization After Coronary Artery Bypass Graft Surgery

Abstract

Objective: To determine whether optimism predicts lower rates of rehospitalization after coronary artery bypass graft surgery for the 6 months after surgery.Methods: A prospective, inception cohort design was used. The sample consisted of all consenting patients (N = 309) from a consecutive series of patients scheduled for elective coronary artery bypass graft surgery at a large, metropolitan hospital in Pittsburgh, Pa. To be eligible, patients could not be scheduled for any other coincidental surgery (eg, valve replacement) and could not be in the cardiac intensive care unit or experiencing angina at the time of the referral. Participants were predominantly men (69.9%) and married (80.3%), and averaged 62.8 years of age. Recruitment occurred between January 1992 and January 1994.Results: Compared with pessimistic persons, optimistic persons were significantly less likely to be rehospitalized for a broad range of aggregated problems (including postsurgical sternal wound infection, angina, myocardial infarction, and the need for another bypass surgery or percutaneous transluminal coronary angioplasty) generally indicative of a poor response to the initial surgery (odds ratio = 0.50, 95% confidence interval = 0.33-0.76; P = .001). The effect of optimism was independent of traditional sociodemographic and medical control variables, as well as independent of the effects of self-esteem, depression, and neuroticism. Allcause rehospitalization also tended to be less frequent for optimistic than for pessimistic persons (odds ratio = 0.77, 95% confidence interval = 0.57-1.05; P = .07).Conclusions: Optimism predicts a lower rate of rehospitalization after coronary artery bypass graft surgery. Fostering positive expectations may promote better recovery. Med. 1999;159:829-835 Arch Intern

Challenges in reducing depression-related mortality in cardiac populations: cognition, emotion, fatigue or personality?

“…This suggests a protective role for positive emotion in medical patients. This protective role of positive emotion has been demonstrated in aetiological studies and CHD samples (Kubzansky, Sparrow, Vokonas, & Kawachi, 2001;Ostir, Peek, Markides, & Goodwin, 2001b;Scheier et al, 1989Scheier et al, , 1999. A 10% reduced risk of incidence of MI per unit increase of positive emotion scores has been demonstrated in older adults, even when controlling for negative affect (Ostir et al, 2001b).…”

Gender differences in health perceptions and meaning in persons living with heart failure

“…[5][6] In contrast, optimism or positive expectations have been related to good physical health and increased compliance among patients after undergoing heart transplantation; that trait optimism was negatively associated with perioperative myocardial infarction and positively associated with rate and extent of lifestyle normalization 30 and decreased total rehospitalizations and complications after coronary artery bypass graft surgery. 31 These findings suggest that optimism has important implications for psychosocial and physical well-being and health satisfaction. Therefore, efforts to promote optimistic expectations and teach patients effective strategies for self-management may reduce stress levels and decrease feelings of dissatisfaction associated with symptom distress and ultimately, increase health perceptions.…”

Felicidade: uma revisão

“…Existem pesquisas que demonstram uma relação do otimismo com: (1) aumento no bem-estar subjetivo (Scheier et al, 1989;Khoo e Bishop, 1997); (2) elevação da auto-estima (Dunn, 1996); (3) baixo índice de depressão (Carver e Gaines, 1987;Marshall e Lang, 1990); (4) baixo índice de emoções negativas (Curbow et al, 1993;King et al, 1998); (5) alto índice de satisfação com a vida (Chang, 1998); (6) boa saúde (Scheier et al, 1999); (7) menor taxa de mortalidade associada a câncer (Schulz et al, 1996); e (8) melhor qualidade de vida (Wrosch e Scheier, 2003).…”