Paper
Friday, July 13, 2007
Role Concerns, Sociological Model of Adaptation To Illness-Related Transitions And Mental Health In Midlife Women Experiencing Acute Myocardial Infarction
Lucia Kamm-Steigelman, RN, PhD, MBA, Nursing Administration, Emory Healthcare, Atlanta, GA, USA and Sandra B. Dunbar, RN, DSN, FAAN, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA.
| Learning Objective #1: familiarize themselves with the sociological model to explain AMI recovery in women. |
| Learning Objective #2: foster discussion about women's social roles including both concerns and rewards and the health implications. |
Background: Midlife women fulfill multiple roles in society including wage-earner, spouse/partner, homemaker, relative, caregiver to children/parents, and volunteer. Experiencing an acute myocardial infarction (AMI) influences roles as well as role concern, and offers the woman an opportunity to re-evaluate their life roles and initiate fundamental changes. Little research exists about the nature of role concern and changes over time. A sociological model of adaptation to illness-related transitions, including variables of personal characteristics, coping through religion, and baseline health characteristics, was used to examine the influence on AMI-related health outcomes. Purpose: This study described role concern and adaptation over time in mid-life women who experienced AMI and examined how role concern influenced mental health outcomes when controlling for relevant personal and health characteristics. Sample: The convenience sample included 50 women, mean age 53.6 years +/-8.19 years. Method: A prospective, longitudinal design was used. Data were collected approximately one week following AMI with participants reporting pre-AMI status (Baseline) and again between 2 to 3 months post hospital discharge. Relationships among socioeconomic status (total family income), age, optimism (Life Orientation Test-Revised), comorbidities (Charlson Co-morbidities Index), severity of AMI (troponin level), role concern (Role Quality Measure), personal importance of religion (Index of Religiousness), baseline mental health and mental health outcomes (SF-36 Physical and Mental Health Summary Scales-Version 2) were examined using descriptive statistics, t tests and multiple regressions. Findings: Using multiple regression, role concern predicted a significant amount of variance (change in R 2 of 5.5%, p<.05) in improved mental health outcomes after controlling for total family income, age, optimism, comorbidities, severity of AMI, personal importance of religion and baseline mental health. Discussion: Healthcare providers, as well as women themselves, should familiarize themselves with the sociological model to explain AMI recovery and encourage discussion about roles including both concerns and rewards.