Psychosocial Variables and Recovery from Coronary Artery Bypass Graft Surgery in Men and Women
Date
2014-05-02
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Abstract
Coronary artery bypass graft surgery (CABG) is performed to improve impairing coronary artery disease (CAD). Although there is interest in how psychosocial factors impact CABG surgery recovery, little research has investigated psychological and social variables in combination in predicting long-term outcomes following CABG surgery. This dissertation examines the association of depression symptoms and social variables with long-term post-CABG outcomes: life function impairment in social and occupational areas (FI), mortality and morbidity. We hypothesize perceived social support will buffer the association between depression symptoms and outcome and associations may differ for men and women. This prospective, observational, single site study recruited 296 (42% female) post-CABG patients of whom 241 (81%; 44% female) participated at one-year follow-up. Depression symptoms, perceived social support, marital status, household responsibility and life function were assessed by self-report questionnaires in-hospital post-CABG and again one-year later. Mortality and CAD procedures were collected over 12 – 15 year follow-up. In adjusted models, greater baseline depression symptoms, lower perceived social support, lower household responsibilities, and not being married predicted greater one-year FI (R2=.20, p<.001). Baseline social support buffered the association between depression and FI in women (b=.14; 95%CI [.04, .23]) and more strongly predicted one-year FI for women (b=.29; 95%CI [.06, .52]). Long-term survival was also associated with one-year psychosocial measures. A one SD increase in depression symptoms led to greater hazard of mortality only at mean (HR = 1.67; 95% CI [1.21, 2.26]) and high social support (HR = 2.23; 95% CI [1.46, 3.40]). Additively, over the five years after follow-up, being married, greater household responsibility and better life functioning were also associated with improved survival. Regarding CAD procedures, only one-year depression symptoms and life function impairment were associated with greater odds of CAD procedure. Overall, this dissertation supports associations of depression symptoms, social variables and life function with long-term outcomes from CABG surgery. Results suggest perceived social support may be more important for women’s functional outcomes, while depression symptoms and being married with more household responsibilities may be important for men and women. Further, results suggest research should investigate timing of interventions for depressed mood and poor social support.
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Psychology--Clinical
Citation
Young, S. N. (2014). Psychosocial Variables and Recovery from Coronary Artery Bypass Graft Surgery in Men and Women (Doctoral thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca. doi:10.11575/PRISM/27477