Living with heart disease: the impact of a cardiac event on patients and their partners

Coronary heart disease (CHD) is a major cause of disease burden and the largest single cause of death in Australia. Continued improvements in detection, prevention and treatment of CHD have resulted in major declines in death rates, meaning that there are now more people living with heart disease than ever before. The aim of this thesis was to explore the patterns of adjustment of cardiac patients and their partners. Adjustment was examined in terms of self-reported health and psychosocial outcomes (changes in lifestyle; psychological distress; perceived support; life satisfaction; relationship satisfaction; posttraumatic growth), with a particular interest in any differences based on gender or role (patient, partner). Study 1 gathered qualitative responses from 56 partners of cardiac patients recruited through a cardiac rehabilitation program. Study 2 gathered both quantitative and qualitative responses from 30 couples in which one member had experienced a cardiac event (heart attack, angioplasty, bypass surgery). Quantitative findings suggested that age was an important factor relating to variability in self-reported health and psychosocial outcomes for both patients and partners, with younger people reporting greater adjustment difficulties than older people. Once age was controlled, only a few gender and/or role effects were found. Women reported greater avoidance than men, while patients reported greater avoidance than partners. Women reported greater posttraumatic growth than men. Male patients and female partners reported greater difficulty making lifestyle changes than female patients and male partners. Analyses of couples’ experiences indicated that perceptions of change in the patient’s mood and the couple’s relationship were related to variability in the psychosocial outcomes, with these effects being more evident for partners than for patients. Qualitative findings confirmed and added greater depth to quantitative results. In particular, difficulties with the recovery process were often related to the need for more information about the potential psychological impact of a cardiac event on the patient. Many people felt unprepared for these changes, which impacted on the quality of the couple’s relationship. Younger respondents noted a need for age appropriate information and support. Perceived benefits resulting from the cardiac event included improved health practices and changes in life perspective. The findings revealed the variety of individual and relationship consequences of a cardiac event, and highlighted the importance of considering couples’ experiences in assessing adjustment of both patients and partners. Results also highlighted the informational and support needs which health care providers need to address in helping couples adjust to the demands of living with heart disease