2008: Coronary heart disease from a psychosocial perspective: socioeconomic and ethnic inequalities among Slovak patients

Project title 2008: Coronary heart disease from a psychosocial perspective: socioeconomic and ethnic inequalities among Slovak patients
Promotor Prof. Dr. Sijmen A Reijneveld
Co-promotors Assoc. Prof. Dr. Jitse P. van Dijk, MD; Dr. Iveta Rajnicova-Nagyova
PhD student Zuzana Skodova
Time period PhD thesis was defended on 15.12.2008
Financial support Bilateral agreement between P.J.Safarik University and University of Groningen; APVV-20-038305; VVGS/019/2006/HV; and Slovak Cardiology Society 2005
Description Aim of the project was to explore an impact of socioeconomic status (income, education) and ethnicity (Roma vs. non Roma) on various psychosocial and medical aspects of the quality of life and recovery process among patients with coronary heart disease.
Main findings Socioeconomic status (SES) was found to be negatively associated with psychological outcomes and perceived quality of life among CHD patients- participants with a low income or education were more likely to have a poor psychological well-being, poor perceived mental health status and a low perceived quality of life compared to participants with high income or education. Patients with low SES were also more likely to report higher vital exhaustion, but these SE differences were significantly more salient among men than among women. Associations between SES and psychological factors remained statistically significant after controlling for the effect of medical variables.Significant ethnic inequalities found among Roma and non/Roma CHD patients has been found as well. In psychological well-being (anxiety, depression), vital exhaustion and health- related quality of life Roma patients scored worse compared to non-Roma. However, some of these differences could be explained by the socioeconomic status of the participants. With regard to personality characteristics, ethnicity played a less significant role.Psychological well-being and vital exhaustion have been shown as significant predictors of positive change in health- related quality of life (HRQL) among CHD patients. The change in the physical HRQL was predicted by baseline psychological well-being and baseline HRQL. The change in the mental HRQL was predicted by (baseline) psychological well-being, vital exhaustion and baseline HRQL. However, these factors were significant only among patients who improved in health- related quality of life, and not among those who remained stable or declined in their HRQL. Socioeconomic status and personality traits (Type D, hostility) were not identified as significant predictors of change.
Dissertation http://dissertations.ub.rug.nl/faculties/medicine/2008/z.skodova/