Longitudinal associations of stressful life events and social support deficits with later functioning in patients with acute coronary syndrome: Social factors for functioning in ACS.

Abstract

BACKGROUND\nIn this study we investigated associations between stressful life events (SLEs) and social support deficit (SSD), which we evaluated within 2 weeks of an acute coronary syndrome (ACS) episode, and changes in functioning, disability, and quality of life (QOL) over a 1-year follow-up period.\n\n\nMETHOD\nIn total, 1152 patients were recruited at baseline within 2 weeks of an ACS episode, and 828 were followed up for 1 year thereafter. The occurrence of SLEs was identified at baseline using the List of Threatening Events , and the participants were categorized into absent or present SLE groups. The SSD was evaluated using the Social Support Scale and was dichotomatized into low or high SSD groups. We measured social and occupational functioning, disability, and quality of life (QoL) at both examinations. The associations between the baseline SLE and SSD with functional changes over 1 year were estimated using repeated-measures analyses of covariance with relevant covariates.\n\n\nRESULTS\nThe presence of SLEs and high SSD at baseline independently predicted worsening of functional disability and QoL over the 1-year follow-up period, after adjustment. Moreover, the coexistence of both present SLE and high SSD indicates negative effects that are more severe on functional outcomes.\n\n\nCONCLUSIONS\nSLEs and SSD at an early phase of ACS predicted chronically poorer functioning and QoL outcomes. Preventive and therapeutic efforts should include strategies to identify and manage psychosocial risk factors in ACS patients.