Konstrukt bolesti i psihološki aspekti prevladavanja kod pacijenata sa infarktom miokarda

Abstract

The main aim of the research was to empirically assess the integrative model of the relationships between the illness representation, cognitive, emotional, and behavioral coping, and functionality of patients who had suffered from a myocardial infarction (MI). The changes in the examined constructs and their mutual relationships through measurements at three stages were also tracked (immediately after the MI, 1.5–2 months later, and 3–4 months later). The research included a sample of 114 patients, hospitalized after experiencing an MI for the first time (M = 54.90, SD = 11.23, 78.1% males). The second and third stage included 67 (response rate 58.77%) and 49 participants (response rate 42.98% compared to the first stage), respectively. The following measures were used: Illness Perception Questionnaire-Revised, IPQ-R; Cognitive Emotion Regulation Questionnaire, CERQ-36; Serbian adaptation of the PANAS; Stendal Adherence with Medication Score – SAMS; Adapted Illness Intrusiveness Ratings, and a Questionnaire designed for this study. The data were collected from the Cardiovascular Diseases Clinic, University Clinical Center Niš, and from the Institute for Cardiovascular Diseases Dedinje. The results showed that the illness representation demonstrated significant direct and/or indirect effects for all of the investigated aspects of coping and functionality after an MI. Some of these relationships were temporally stable, while others appeared as dynamic, owing to changes in the investigated constructs over time. Cognitive coping appeared as a mediator in the relationship between the illness representation and various health-relevant outcomes – emotional, behavioral, and functional. The hypothesized serial or parallel mediation of the cognitive, emotional, and behavioral coping in the relationship between illness representation and patient functionality after an MI could not be confirmed. These relationships were more complex than expected, and they exhibited temporal dynamics. The results were interpreted in line with the common-sense model and compared with findings from previous research.