Psycho-social aspects of recovery from coronary heart disease: A review

Abstract

The literature dealing with the psychological and social aspects of recovery from and rehabilitation to the acute onset of coronary heart disease (CHD) was reviewed. The papers published since an earlier review were placed into one of three categories: advocacy articles, generally describing psychological reactions of patients and advocating a particular treatment; clinical papers, dealing with impressionistic observations of the emotional state of patients and their spouses; empirical reports, exploring various scientific issues regarding social-psychological functioning. Research quality and quantity have increased greatly in the past eight years. There is little question that CHD results in the temporary disruption of normal psychological and social functioning. Long-lasting emotional distress, familial problems, and occupational maladjustment are observed in a significant minority of patients. Psychosocial counseling appears to facilitate and hasten rehabilitation. However, additional programmatic evaluation studies are required in order to assess which psycho-therapeutic procedures are essential and should be a routine part of treatment of acute CHD patients and their families.

Accustomed to enduring: Experiences of African-American women seeking care for cardiac symptoms

“…12 Most of the observed delay, consistent with other studies, was related to the time it took patients to decide to seek medical care after symptom onset. 18,19 Ghali et al evaluated prehospital delay in 74 African-American patients admitted at Cook County hospital in Chicago, Illinois. Patients with AMI had a median delay time of 3 hours from onset of chest pain to decision to seek medical care compared 14 with 1 hour in studies of AMI patients with predominately white samples.…”

Approaches to Taxonomy and Measurement of Adaptation in Chronic Disease

“…1973], (b) contradicting ap proaches toward systematization and forma tion of hierarchies and (c) neglect of the situ ative context. To illustrate the latter point, while denial has often been considered coun terproductive in psychotherapy, it has been demonstrated to have at least some adaptational value during the early phases of hospi talization for myocardial infarction [Doehrman, 1977], Defense mechanisms pose special meth odological problems. In general, operational ization can be done via self-rating or expert rating, based on interview or behavioral ob servation.…”

Use of medical care for chest pain: differences between blacks and whites.

“…The both the severity of the symptom and an individual's flexibility to respond at the time of symptom onset will contribute to delay in receiving care. 35,36 Blacks and Whites also may view the likely efficacy of visiting the doctor differently. Perceived efficacy, an important predictor of care-seeking by symptomatic individuals,37,38 was different in this population when treatment for hypertension was assessed.24 Hypertensive Black adults were found to have less confidence in the net benefit of anti-hypertensive medication, and this attitude was associated with a greater likelihood of being untreated for diagnosed hypertension.…”