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UPBEAT study patients' perceptions of the effect of coronary heart disease on their lives: A cross-sectional sub-study

Smith, Alison, Fortune, Z., Phillips, Rachel, Walters, Paul, Lee, Geraldine A., Mann, Anthony, Tylee, Andre and Barley, Elizabeth A. (2014) UPBEAT study patients' perceptions of the effect of coronary heart disease on their lives: A cross-sectional sub-study International Journal of Nursing Studies, 51 (11). pp. 1500-1506.

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Background: Patients can report positive effects of myocardial infarction. It is unknown whether these effects are sustained or what factors influence adaptation. Objectives: To explore primary care patients' perceptions of the effect of coronary heart disease and to identify possible modifiable predictors of adaptation. Design and setting: Cross-sectional, sub-study of UPBEAT cohort participants. Patients were recruited from coronary heart disease Registers in South London General Practices. Method: 548 participants were asked "Has having heart disease changed your life? If so, was that change for the better, worse, both or neither?" Participants were asked to explain their response; explanations were subjected to content analysis. Associations between response and lifestyle, demographic, mood and coronary heart disease variables were tested. Results: Respondents (394 male, 72%) were aged 27-98 years and had had heart disease for a mean of 12.4 SD ± 8.4 years. 120 (22%) reported that life was better and 200 (37%) said it was worse. The explanations of those who said 'better' were categorised as 'Healthier Living', 'Recognised Mortality' and 'Stress Reduction'. For those saying 'worse', categories were 'Restricted Lifestyle', 'Recognised Mortality', 'Loss and Burden'. More anxiety symptoms (RRR 1.56, 95% CI 1.12, 2.17), lower functional status (RRR 2.46, 95% CI 1.21, 4.98) and self-reported chest pain (RRR 2.24, 95% CI 1.34, 3.77) were associated with saying 'worse'. Conclusions: Many primary care patients are ambivalent to the effects of coronary heart disease, but some report positive effects. Negative perceptions are associated with reported functional impairment, chest pain and anxiety, but not illness severity or patient characteristics. Future work will track the implications of these perceptions, but nurses managing patients with coronary heart disease should consider these effects as they may be modifiable predictors of adaptation. © 2014.

Item Type: Article
Divisions : Faculty of Health and Medical Sciences > School of Health Sciences
Authors :
Fortune, Z.
Phillips, Rachel
Walters, Paul
Lee, Geraldine A.
Mann, Anthony
Tylee, Andre
Barley, Elizabeth
Date : 18 April 2014
DOI : 10.1016/j.ijnurstu.2014.04.006
Copyright Disclaimer : 0020-7489/Crown Copyright ß2014 Published by Elsevier Ltd. This is an open access article under the CCBY-NC-SA license(
Uncontrolled Keywords : Affect, Attitudes, Coronary heart disease, General practice, Perception, Primary health care, adult, aged, coronary artery disease, cross-sectional study, female, human, male, middle aged, psychology, very elderly, Adult, Aged, Aged, 80 and over, Coronary Disease, Cross-Sectional Studies, Female, Humans, Male, Middle Aged
Depositing User : Diane Maxfield
Date Deposited : 19 Jul 2019 14:01
Last Modified : 19 Jul 2019 14:01

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