Older adults who survive a myocardial infarction (MI) tend to have more severe illness than their younger counterparts, are frequently depressed, have more comorbid conditions and are less medically adherent. Interventions are needed to improve the elderly patient's sense of self-efficacy and increase medical adherence and motivation for cardiac rehabilitation. This revised R21 seeks support to assess the feasibility of a brief social psychological intervention to achieve these goals among older post-Mi patients who have just recently returned home from the hospital. Application of a new social psychological theory, the Interpretation-Comparison model, suggests a means by which a patient's learning about how other fellow patients are coping may increase self-efficacy and motivation. Specifically, it is predicted that instructing participants to explicitly compare with another patient who is coping very well or exposing participants (without explicit instructions to compare) to another patient who is coping poorly will result in positive outcomes. This prediction will be tested in a sample of approximately 127 post-Mi patients (65+ years). Self-efficacy, quality of life, and perceived symptoms will be assessed prior to and immediately following the comparison exposure and at 4-, 12- and 20 weeks. Actual attendance at cardiac rehabilitation will also be assessed. Depression, which is common in older post-Mi patients, will be measured in the baseline interview and at follow-up and also will be evaluated as a potential moderator of comparison intervention effects. This intervention is not intended to replace more intensive psychosocial interventions and home-based case-management approaches, but it may effect change during the critical post-discharge period when cardiac patients are still in the process of making decisions about significant lifestyle changes and may increase their enrollment in cardiac rehabilitation. The results also should shed light on the kinds of patient models and instructions that may be most beneficial in educational videos used in rehabilitation, and suggest when social comparisons in social support groups can be productive or counterproductive to patient coping. Although the present research focuses on adaptation to cardiac disease, results should also be relevant and exportable to older adults that are coping with other chronic illnesses.
| Suls, Jerry; Martin, René (2011) Heart disease occurs in a biological, psychological, and social matrix: cardiac risk factors, symptom presentation, and recovery as illustrative examples. Ann Behav Med 41:164-73 |
| Howren, M Bryant; Suls, Jerry (2011) The symptom perception hypothesis revised: depression and anxiety play different roles in concurrent and retrospective physical symptom reporting. J Pers Soc Psychol 100:182-95 |
| Shin, Ju Young; Martin, Rene; Suls, Jerry (2010) Meta-analytic evaluation of gender differences and symptom measurement strategies in acute coronary syndromes. Heart Lung 39:283-95 |
| Howren, M Bryant; Suls, Jerry; Martin, René (2009) Depressive symptomatology, rather than neuroticism, predicts inflated physical symptom reports in community-residing women. Psychosom Med 71:951-7 |
| Shin, Ju Young; Suls, Jerry; Martin, Rene (2008) Are cholesterol and depression inversely related? A meta-analysis of the association between two cardiac risk factors. Ann Behav Med 36:33-43 |
