Patient satisfaction with treatment after acute myocardial infarction: role of psychosocial factors

Psychosom Med. 2007 Feb-Mar;69(2):115-23. doi: 10.1097/PSY.0b013e31802f2785. Epub 2007 Feb 8.

Abstract

Objective: To determine if psychosocial status influences treatment satisfaction, a quality-of-care indicator, of patients who were hospitalized for acute myocardial infarction (AMI).

Methods: Psychosocial variables (social support, dispositional optimism, and depression) were assessed in 1847 AMI patients who completed a 1-month assessment in Prospective Registry Evaluating Myocardial Infarction: Events and Recovery (PREMIER), a multicenter, prospective cohort study. Patients' treatment satisfaction was determined using the Treatment Satisfaction scale of the Seattle Angina Questionnaire. The association between psychosocial variables and treatment satisfaction-adjusted for site, sociodemographics, medical history, clinical presentation, and treatment procedures-was evaluated using a censored normal model.

Results: Study participants were primarily white (77.6%) and male (68.8%), with a mean age of 60.6 +/- 12.7 (SD) years. Satisfaction with posthospitalization treatment following AMI increased as social support (Wald chi(2) = 35.02, p < .001) and dispositional optimism (beta = 1.42; 95% CI 0.24, 2.60) increased. Participants with mild (-3.10, 95% CI -5.77, -0.44), moderate (-4.77, 95% CI -8.16, -1.38), moderately severe (-8.49, 95% CI -13.47, -3.52), and severe (-11.65, 95% CI -18.77, -4.53) depression had significantly worse treatment satisfaction compared with the nondepressed participants.

Conclusion: Assessing psychosocial variables, such as social support, dispositional optimism, and depression severity before hospital discharge, may indicate who is likely to be more satisfied with posthospitalization cardiac care 1 month following AMI. Without controlling for psychosocial status, treatment satisfaction may be a biased indicator of quality. Future studies should evaluate whether psychosocial intervention after AMI can improve satisfaction.

Publication types

  • Multicenter Study
  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Aged
  • Attitude
  • Depression
  • Female
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction / psychology*
  • Myocardial Infarction / therapy*
  • Patient Satisfaction*
  • Prospective Studies
  • Severity of Illness Index
  • Social Support