Depression Clinical Trial
To study the personality and environmental factors that may determine the short-term and long-term sequelae of coronary artery bypass surgery (CABS).
BACKGROUND:
Coronary artery bypass surgery, or CABS, is one of the most common surgical procedures for
treating patients with coronary artery disease (CAD). A significant number of patients have
accelerated atherosclerosis in the postsurgical period and require second and third
operations. Moreover, relative to standard medical care, CABS does little to prolong life.
The major benefit of the procedure is improving life quality. Thus, to enhance this major
benefit of CABS, it is important to understand the factors, psychosocial as well as
biological, that might enhance quality of life after CABS. The few available studies on the
psychosocial aspects of recovery from CABS suggest that person variables evident prior to
surgery are related to postsurgery quality of life. Of special interest here are gender,
optimism, Type A, with its component behavior of hostility, and repressive style. The
significance of these attributes derives from their theoretical and empirical relationships
to the patient's illness representations and correspondent coping responses, and/or their
relationship to risk for coronary heart disease (CHD). In addition to person variables, a
number of environmental variables might also be expected to play a role in recovery.
Variables such as socioeconomic status (SES), major life events, and quantity and quality of
social support systems have all been shown to impact on health and illness. Moreover, from a
slightly different perspective, the patient's illness itself can serve as an environmental
variable impinging on the life of the person providing the primary support. Thus, it is also
important to understand how the patient's illness impacts on the provider of the primary
support.
DESIGN NARRATIVE:
A total of 305 patients between the ages of 25 and 70 scheduled for elective surgery at a
major local hospital were evaluated two weeks prior to surgery on the day prior to surgery,
and one week, six months, and two and a half years postsurgery. Primary support persons were
evaluated three times--at intake, six months postsurgery, and two and a half years
postsurgery. Medical information was obtained that permitted examination of the influences
of psychosocial variables on recovery. Major personality variables under investigation were
optimism, Type A, hostility, gender, repressive style, and to a lesser extent, anxiety, and
neuroticism. Major environmental variables included quality and quantity of social support
and availability of a primary support person. Main outcome variables for patients included
satisfaction with different life domains, depression, return to work, normalization of life
style, and new and recurrent morbidity. Main outcome variables for the support person
included perceptions of burden, depression, and life satisfaction.
The study completion date listed in this record was obtained from the "End Date" entered in
the Protocol Registration and Results System (PRS) record.
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