UCSF

ABSTRACT

Illness Perception, Depression, Anxiety and Quality of Life in Older Adults

Post Coronary Heart Disease Event

Mahmood Khosravi

America is aging. Adults, 65 years and older, comprise nearly 13% of the population. Coronary heart disease (CHD) is the leading cause of mortality in adults 65 years and older. As a chronic illness, CHD can lead to decreased health-related quality of life (HRQOL) and increased depression, anxiety and health expenses. Illness perception, the way in which people view illness, has been linked to health outcomes. As people age, illness perceptions and coping strategies to deal with a health threat can change, but there is a paucity of literature about how older adults view illness and how it affects their health outcomes. Within the context of Leventhal’s self-regulation theory, the dissertation purpose was threefold: (1) describe and identify gaps in the illness perception literature specific to older adults with CHD, (2) examine the relationship between illness perception, depression, anxiety and HRQOL among older adults who have experienced a CHD event, and (3) describe the illness perceptions of older adults participating in cardiac rehabilitation post-CHD event, taking into consideration sociodemographic characteristics.

The convenience sample of 58 older adults was comprised of 47 men and 11 women recruited from cardiac rehabilitation centers in the San Francisco Bay Area. The predominantly White, non-Hispanic sample ranged in age from 65 to 88 years with a mean age of 74 years. Participants responded to the Hospital Anxiety and Depression Scale, the Illness Perception Questionnaire Revised, and the RAND 36-item Health Survey to measure HRQOL. Health and sociodemographic data were also collected. Despite participants believing their CHD would be chronic, CHD symptoms would fluctuate and occur often, CHD would have negative consequences, and CHD caused distress, they believed CHD could be controlled and treated and understood CHD. Participants were at low risk for anxiety and depression and had above average mental and physical HRQOL. Varying dimensions of illness perception contributed significantly to the variance in depression, anxiety and HRQOL. Statistically significant differences in illness perceptions varied by sociodemographic characteristics. Study findings highlight the importance of cardiac rehabilitation nurses intervening to address older adults’ illness perception and its effect on emotional, psychological and physical health and wellbeing.