Adaptation after treatment for heart disease: Preliminary examination within a stress appraisal context

Objective: To examine, within a stress appraisal framework, intrapersonal psychosocial factors that may affect adaptation after treatment for heart disease. Hostility was examined as a variable that may affect cognitive appraisal of stress and, thus, adaptation. Design: Quasi-experimental design with measures before and after treatment. Setting: Large, Midwest hospital preadmitting department with follow-up by mail 1 month after treatment. Outcome Measure: Adaptation, operationalized as perceived quality of life. Results: There was a significant, positive relation between hostility and cognitive appraisal of heart disease threat. Threat appraisal and state anxiety before treatment were significantly inversely related to posttreatment quality of life. Hostility was modestly, although nonsignificantly inversely related to posttreatment quality of life. Results provide tentative support for the theory-defined role of appraisal as a mediator between hostility and quality of life. Conclusions: Stress appraisal theory is tentatively supported as a useful framework for examining the adaptational outcome of quality of life in patients with heart disease. (Heart Lung® 1999;28:186-94)