The purpose of the present research is to identify the correlates of successful Psychological and Physical adjustment to chronic illness, utilizing the framework of cognitive adaptation theory (CAT). According to CAT, successful adjustment to chronic illness is accomplished by maintaining an optimistic outlook, feeling a sense of control over the illness, enhancing one's self-esteem, and deriving meaning from the experience. Much of the research on CAT has been conducted with cancer patients, and the specific components of the theory are vague, leaving many questions unanswered. The first goal of the proposed research is to determine the extent to which CAT describes successful adjustment to a second major chronic illness, coronary heart disease (CHD). To this end, clarifications and refinements in the components of the theory are made. The second goal of the proposed research is to broaden the scope of CAT by asking what implications the theory has for adjustment to an illness recurrence. Adjustment to recurrence is an important issue in chronic illness. The recurrence in the present study is a treatment failure, specifically restenosis following non-emergent percutaneous transluminal coronary angioplasty. Restenosis occurs in 1/3 of angioplasty patients within 6 months following hospital discharge. All English-speaking persons ages 35 to 70 who are admitted to a hospital for a first coronary event treated successfully with angioplasty will be eligible for the proposed research. Personal interviews will be conducted with patients shortly before hospital discharge and 6 months following discharge. Phone follow-up interviews will be conducted 12 months after discharge. The components of CAT will be assessed during the two personal interviews,, and psychological distress and physical health status will be assessed during all three interviews. At 6 months and 12 months, it will be determined whether restenosis of the angioplasty has occurred (by patient and physician), so that the extent to which CAT predicts adjustment to treatment success and failure can be examined.
| Helgeson, V S; Fritz, H L (1999) Cognitive adaptation as a predictor of new coronary events after percutaneous transluminal coronary angioplasty. Psychosom Med 61:488-95 |
