A study of 536 Ohio patients with a variety of heart problems showed that women reported poorer physical and psychological functioning than did men immediately after hospital treatment and for a year following.
Social support may be one key as to why women do more poorly, especially in their psychological functioning, said Charles Emery, one of the leaders of the study and an associate professor of psychology at Ohio State University.
"For women, lower quality of life was associated with feeling they didn't have enough support from friends and family," Emery said. "But levels of social support did not influence psychological functioning among men."
This study is significant because it is one of few that have compared how men and women cope with heart disease over time, he said. Emery presented results of the study Aug. 22 in Chicago at the annual meeting of the American Psychological Association.
The biggest difference between men and women was the influence of social support on quality of life. Only among women was the absence of social support associated with poor quality of life
Emery and his colleagues studied patients with heart problems who were admitted to Ohio State University Medical Center during a 14-month period. The average age of the patients was 59.5 years and 35 percent were women. While most cardiac studies include only patients following heart attacks or bypass surgery, this study included patients with any heart-related diagnoses, including unstable angina, congestive heart failure, dysrhythmia, valve surgery and transplant surgery.
After being admitted to the hospital, participants filled out a standard questionnaire that measured physical and psychological functioning. They were asked questions about their physical well-being, such as how well they could perform everyday tasks like climbing stairs, bathing and dressing. They were also asked about their mental quality of life: whether they felt full of energy or were tired all the time, whether they were nervous or depressed, and whether they had problems at work or other daily activities because of emotional problems.
A separate questionnaire measured social support - whether they had family or friends with whom they could discuss problems, socialize, or who could help with everyday tasks. Participants then completed these measures again every three months for one year.
Results showed that women had lower psychological and physical functioning at each time point during the study, Emery said. Quality of life improved slightly for both men and women until the final measurement at one year, when scores dropped off slightly. The change in scores over time was similar for both men and women. The results held true regardless of type of heart problem, age, race, or cardiac risk factors.
The biggest difference between men and women was the influence of social support on quality of life. While men and women showed similar levels of social support, it was only among women that the absence of social support was associated with poor quality of life, Emery said.
Quality of life was lowest among women who reported having few friends or family to do things with or to socialize with. "Women with heart disease need people to talk to and spend time with," Emery said. "Friendship and companionship appears to be extremely important for their well-being."
Men in our society are socialized to not depend as much on friends and family for their well-being, he said. In addition, for men of working age, the workplace might provide a form of social support that is not as readily available for women, especially older women.
These results suggest that heart disease treatment for women shouldn't stop when they get out of the hospital. Group therapy might be one way of boosting social support among women cardiac patients, he said.
"Certainly in other patient populations, such as women with breast cancer, we have seen the benefits of group therapy," Emery said. "But it typically hasn't been done in women with heart disease. In standard cardiology practice there hasn't been a focus on longer-term care and rehabilitation. We need to pay more attention to that aspect of treatment."
Emery conducted the study with David Frid of Pfizer Inc.; Stephen Stern, University of Texas Health Science Center; Anne Fish, University of Missouri; and the following, all from Ohio State: Tilmer Engebretson, adjunct assistant professor of psychology; Angelo Alonzo, professor of sociology; Amy Ferketich, lecturer; Nancy Reynolds, associate professor of nursing; Jean-Pierre Dujardin, associate professor of physiology and cell biology; Joann Homan, cardiology nurse.
Written by Jeff Grabmeier, (614) 292-8457; Grabmeier.1@osu.edu
[EMBARGOED FOR RELEASE UNTIL 7:00 A.M. EDT, AUGUST 22, 2002, TO COINCIDE WITH PRESENTATION AT THE ANNUAL MEETING OF THE AMERICAN PSYCHOLOGICAL ASSOCIATION IN CHICAGO.]