Sense of Coherence and Health-Related Quality of Life among Patients Undergoing Coronary Artery Bypass Grafting or Angioplasty

Abstract

Every year, 4 million people die from cardiovascular disease (CAD) in Europe. As many as 800,000 of them die before they reach the age of 65. The ischemic heart disease is also the most common cause of death in Finland. The invasive treatments of the CAD, coronary artery bypass grafting (CABG) and percutaneous transluminal coronary angioplasty (PTCA) relieve symptoms and increase patient's health-related quality of life (HRQoL) in most of the cases. In this paper sense of coherence is discussed as related to health-related quality of life among CABG and PTCA patients in a one-year follow-up. The study sample consisted of consecutive male (N=439) and female (N=176) patients who were treated with the elective CABG or PTCA. The baseline data before the interventions were collected by structured interviews, the follow-up data by mailed self-administered questionnaires six and twelve months afterwards. The sense of coherence was studied by using a 13-item SOC scale. HRQoL was measured by the 15D. It is a generic, multidimensional, standardized, self-administered instrument, which has both a profile and single index score property. The differences in both groups were defined by using T-tests. Follow-up outcomes were analysed by using analyses of variance for repeated measures. Health-related quality of life increased in both groups during the follow-up. There was a correlation between health-related quality of life and sense of coherence in CABG and PTCA patients' group at baseline. The mean score of the 15D was lower in moderate sense of coherence tertile than in strong sense of coherence tertile in both groups. After six and twelve months the similar tendency existed in health-related quality of life and sense of coherence; patients who had poor or moderate sense of coherence had lower health-related quality of life than the patients with strong sense of coherence. Sense of coherence was more stable among CABG patients than PTCA patients. In PTCA patients' group sense of coherence decreased during the follow-up time. In both patients' group the health-related quality of life increased statistically significant by 6 months. No significant change in health-related quality of life took place in either group from 6 to 12 months.