EFFECTS OF PERSONALITY & CONTEXT ON RECOVERY FROM CABS

冠状动脉搭桥手术（CABS）是最常见的手术之一 用于治疗冠状动脉疾病患者的外科手术 （CAD）。 相当数量的患者有加速动脉粥样硬化 在手术后阶段，需要第二次和第三次手术。 此外，相对于标准的医疗护理，CABS几乎没有延长 生活 该手术的主要好处是提高生活质量。 因此，为了增强CABS的这一主要优势， 了解心理社会因素和生物因素， 提高CABS后的生活质量。 关于从精神分裂症中恢复的社会心理方面的少数研究 CABS表明，手术前明显的个人变量是相关的 对术后生活质量的影响。 这里特别感兴趣的是性别， 乐观，A型，其组成行为的敌意， 压抑的风格 这些属性的重要性来自于 它们与病人病情的理论和经验关系 陈述和相应的应对反应，和/或其 与冠心病（CHD）风险的关系。 除了 人的变量，一些环境变量也可能是 希望在复苏中发挥作用。 社会经济等变量 社会经济地位（SES），主要生活事件，社会数量和质量 所有支助系统都显示出对健康和疾病的影响。 此外，从一个稍微不同的角度来看，病人的疾病 它本身可以作为一个环境变量， 提供主要支持的人。因此，还必须 了解患者的疾病如何影响提供者 主要支持。 我们建议研究可能导致 确定CABS的短期和长期后遗症。360例患者 年龄在25岁到70岁之间， 将在手术前两周对当地一家大医院进行评估， 手术前一天、一周、六个月和两年半 手术后 将对主要支助人员进行三次评估， 入院时、术后6个月和术后2年半。 医疗 将获得的信息将允许我们检查 心理社会变量对恢复的影响，独立于主要因素 CAD的危险因素 调查中的主要人员变量将 乐观，A型，敌意，性别，压抑的风格，和一个较小的 程度、焦虑和神经质。主要环境变量包括 社会支助的质量和数量以及初级教育的提供情况 支持的人。 患者的主要结局变量包括 对不同生活领域的满意度，抑郁，重返工作， 生活方式正常化，新发和复发性疾病。 主要 支持人员的结果变量将包括对 负担、抑郁和生活满意度。

Coronary artery bypass surgery, or CABS, is one of the most common surgical procedures for treating patients with coronary artery disease (CAD). A significant number of patients have accelerated atherosclerosis in the postsurgical period and require second and third operations. Moreover, relative to standard medical care, CABS does little to prolong life. The major benefit of the procedure is improving life quality. Thus, to enhance this major benefit of CABS, it is important to understand the factors, psychosocial as well as biological, that might enhance quality of life after CABS. The few available studies on the psychosocial aspects of recovery from CABS suggest that person variables evident prior to surgery are related to postsurgery quality of life. Of special interest here are gender, optimism, Type A, with its component behavior of hostility, and repressive style. The significance of these attributes derives from their theoretical and empirical relationships to the patient's illness representations and correspondent coping responses, and/or their relationship to risk for coronary heart disease (CHD). In addition to person variables, a number of environmental variables might also be expected to play a role in recovery. Variables such as socioeconomic status (SES), major life events, and quantity and quality of social support systems have all been shown to impact on health and illness. Moreover, from a slightly different perspective, the patient's illness itself can serve as an environmental variable impinging on the life of the person providing the primary support. Thus, it is also important to understand how the patient's illness impacts on the provider of the primary support. We propose to study the person and environmental factors that may determine the short-term and long-term sequelae of CABS. 360 patients between the ages of 25 and 70 who are scheduled for elective surgery at a major local hospital will be evaluated two weeks prior to surgery on the day prior to surgery, and one week, six months, and 2 1/2 years postsurgery. Primary support persons will be evaluated three times--at intake, 6 months postsurgery, and 2 1/2 years postsurgery. Medical information will be obtained that will permit us to examine the influences of psychosocial variables on recovery, independent of major risk factors for CAD. Major person variables under investigation will be optimism, Type A, hostility, gender, repressive style, and to a lesser extent, anxiety, and neuroticism. Major environmental variables include quality and quantity of social support and availability of a primary support person. Main outcome variables for patients will include satisfaction with different life domains, depression, return to work, normalization of life style, and new and recurrent morbidity. Main outcome variables for the support person will include perceptions of burden, depression, and life satisfaction.