Gender differences in adjustment to acute myocardial infarction.

OBJECTIVE: To compare psychosocial adjustment, functional class, and return to work in a matched sample of women and men experiencing a first acute myocardial infarction (AMI).

DESIGN: Longitudinal survey.

SETTING: Subjects were identified from six hospitals in the Southern California area. Data were collected in the home setting 1 and 4 months after hospital discharge.

SUBJECTS: Data on 32 women experiencing a first AMI were matched on neuroticism and cardiac dysfunction with 32 men from the same sample.

MEASURES: The following instruments were administered 1 and 4 months after hospital discharge: Self-Perception Inventory (self-esteem); Profile of Mood States (emotional distress); General Health Perceptions Questionnaire (health perceptions); Interpersonal Dependency Inventory (dependency); and the UCLA Social Support Inventory (social support). The Eysenck Personality Inventory (neuroticism) was administered at 1 month. Cardiac dysfunction was measured with data available from the hospital record. Functional class was measured at 1 month with the Specific Activity Scale. Self-report of demographics and return to work were obtained 1 and 4 months, respectively.

RESULTS: Women experienced improved perceptions of current health whereas their ratings of prior health decreased. Overall emotional distress, anxiety, and depression decreased significantly over time in women. Women reported wanting, receiving, and giving more support than men did at 1 month and receiving and giving more support than men did at 4 months, although stress in support relationships rose over time. In men anxiety, depression, and health concern all decreased significantly over time whereas their ratings of prior health rose. The match between social support wanted and received decreased over time in males as did their satisfaction with the support received. Men reported a higher functional class than women at 1 month, but return to work at 4 months did not differ.

CONCLUSIONS: Both women and men experienced improved psychologic adjustment within 4 months after AMI, although the specific areas of improvement differed. Return to work was comparable in spite of differences in functional class. The women appeared to activate their social support system more effectively than the men after AMI. Further research is needed to determine whether differences in social support contribute to adjustment that is better than what normative data predict for women.