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Abstract

An extensive amount of research has been conducted on mortality and morbidity in patients
who have experienced an acute cardiac event. The literature includes findings regarding
predictors of attendance and adherence to Cardiac Rehabilitation (CR) Programmes and
factors which are related to the development of Coronary Heart Disease (CHD). This
literature discusses the factors that predict health behaviours and perceptions of general
health; socio-demographic variables, depression, social support and coping. Specifically,
lower socioeconomic status is related to higher levels of stress hormones, greater likelihood of
smoking, less likelihood of eating breakfast, and less diverse social networks. Depression and
CHD appear to be independent risk factors for the development of each other. Being in an
intimate relationship is associated with less mortality after an acute cardiac event, while active
coping styles are associated with positive well-being at later time points after heart attack.
Despite the extensive research in this area, the mechanisms underlying the relationships
between these factors remain unclear. Also, a large amount of variance in health and health
behaviour accounted for by psycho-social and demographic variables overlap. Hence little is
known about the unique variance accounted for by these factors.
Coronary heart disease (CHD) is the leading cause of death in Australia. An extensive body of
research has been conducted into factors related to positive health outcomes and health
behaviour in people with CHD. This research indicates that psycho-social and demographic
factors play an important role in determining adjustment in patients after an acute cardiac
event, but also in the development of CHD. Despite the extensive research on this topic, many
questions remain regarding the underlying mechanisms behind the relationships between
psychosocial and demographic variables and general health and health behaviour. The present
study aims to build on the understanding of these relationships. Specifically, the study looks
at the unique variance in patients' perceived overall general health and health behaviour
accounted for by education, depression, Body Mass Index (BMI) social support and coping.
The participants were 57 people who had either been diagnosed with CHD or had been
advised to make changes to their lifestyle for their heart health because of high risk for
developing CHD. They were recruited through the UTAS School of Psychology on-line study
web page, a General Practitioner, and an allied-health professional at the Royal Hobart
Hospital. Participants completed a one-off assessment booklet either on-line or via a mail out
survey. Three separate hierarchical multiple regressions were employed to investigate the
aims of the study. The first used level of educational attainment, depression, social support
(satisfaction and size of social network) and coping effort to predict unique variance in
perceived overall general health. The second used BMI, social support (satisfaction and size
of social network) and coping to predict unique variance in intention to exercise. The third
regression used social support (satisfaction and size of social network) and coping effort to
predict unique variance in intention to eat a healthy diet. Consistent with the hypotheses,
higher levels of educational attainment predicted better overall perceived general health. Also
as predicted, lower levels of depression were related to high levels of perceived overall
general health. Contrary to predictions, social support (satisfaction and size of social network)
and coping effort were not found to be related to health. The hypothesis that a greater BMI
would be predict lower intention to exercise was supported, as was the hypothesis that a larger
social network would be associated with intention to exercise. Satisfaction with social
support and coping effort were not found to be related to intention to exercise. The hypothesis
that a larger social network would be associated with a greater intention to eat a healthy diet
was supported by the findings, however, satisfaction with social support and coping effort
were not found to be related to intention to eat a healthy diet. It was concluded that depression
and level of educational attainment are of great importance when considering factors
associated with positive general health outcomes in people with CHD and heart health
concerns. This has implications for health care professionals, with regards to primary and
secondary prevention of CHD in people with low levels of educational attainment and also the
importance of screening for depression in people after a diagnosis of CHD.

Item Type:	Thesis - Coursework Master
Authors/Creators:	Young, Annabelle
Keywords:	Coronary heart disease, Coronary heart disease, Health behavior
Copyright Holders:	The Author
Copyright Information:	Copyright 2010 the Author - The University is continuing to endeavour to trace the copyright owner(s) and in the meantime this item has been reproduced here in good faith. We would be pleased to hear from the copyright owner(s).
Additional Information:	Thesis (MPsych(Clin))--University of Tasmania, 2010. Includes bibliographical references
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