Psychosocial and Medical Predictors of 1-Year Functional Outcome in Male and Female Coronary byPass Recipients

Abstract

Background and Purpose: This study examines coronary artery bypass graft (CABG) patients, their baseline medical and psychosocial characteristics, and level of functioning after 1 year. Functioning was defined as ability to play their role in social, family, recreational, and occupational areas. Sex differences and the buffering effect of social support were also investigated. Methods: This prospective, observational study recruited 296 (42% female) post-CABG patients, of whom 234 (79%; 44% female) had complete data at 1-year follow-up. Clinical and demographic variables were collected following surgery via chart review and provincial database. Depressive symptoms, perceived social support, household responsibilities, marital status, pain, and role interference were assessed at baseline and 1 year later. Hierarchical linear regression examined relationships between baseline psychosocial variables and 1-year role interference controlling for potential medical confounding variables. Results: One-year role interference was partially predicted by baseline depression, social support, household responsibilities, and marital status (R 2 = 0.20,P < 0.001), but not disease severity. Baseline depression predicted 1-year role interference only at mean (b = 0.15, 95% confidence interval [CI] [0.01, 0.31]) and high (b = 0.30, 95% CI [0.12, 0.48]) perceived social support. Baseline perceived social support predicted greater reduction in 1-year role interference in women compared to men (interaction b = 0.29; 95% CI [0.06, 0.52]) and reduced the association between high depression symptoms and role interference in women only (b = −0.25, 95% CI [−0.42, −0.09]). Conclusions: Long-term role interference in bypass graft recipients was not associated with disease severity, but was predicted by social variables and depressive symptoms. In women perceived social support moderated the association between depression and role interference.