Yael Benyamini1, Yariv Gerber2, Noa Molshatzki2, Uri Goldbourt2, Yaacov Drory3. 1. Bob Shapell School of Social Work, Tel Aviv University. 2. Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University. 3. Department of Rehabilitation, Sackler Faculty of Medicine, Tel Aviv University.
Abstract
OBJECTIVE: Following the trajectory hypothesis for the validity of self-rated health (SRH), we tested whether subjective recovery of health, that is, return to the same or higher level of SRH after a major health event, independently predicts better long-term prognosis. METHODS: Participants were 640 patients (≤ 65 years) admitted to the eight medical centers in central Israel with incident MI in a 1-year period (mean age 54, 17% female). Baseline data were collected within days of the index MI. SRH in the preceding year was assessed at baseline, and current SRH was assessed 3-6 months later. Recurrent ischemic events (recurrent MI, hospitalization with unstable angina pectoris, or cardiac death) were recorded during a mean follow-up of 13 years. RESULTS: A reduced risk of recurrent events was associated with an upward change of one level (e.g., from 3 at T1 to 4 at T2) in SRH (HR = 0.76, 95%CI: 0.69-0.85), controlling for baseline retrospective SRH. Risk was still significantly lower for each unit of improvement after adjusting for sociodemographics, preevent comorbidity, cardiac risk factors, MI severity, and early post-MI events (HR = 0.85, 95% CI 0.75-0.95). CONCLUSIONS: Individuals who perceived themselves 3-6 months after a first MI to be healthier than they had been in the year preceding the MI were more likely to survive event-free throughout the next 13 years, controlling for baseline retrospective SRH and multiple cardiac risk factors. Failure to experience such subjective recovery of one's health is a serious risk factor, which indicates that SRH should be monitored regularly after a MI.
OBJECTIVE: Following the trajectory hypothesis for the validity of self-rated health (SRH), we tested whether subjective recovery of health, that is, return to the same or higher level of SRH after a major health event, independently predicts better long-term prognosis. METHODS:Participants were 640 patients (≤ 65 years) admitted to the eight medical centers in central Israel with incident MI in a 1-year period (mean age 54, 17% female). Baseline data were collected within days of the index MI. SRH in the preceding year was assessed at baseline, and current SRH was assessed 3-6 months later. Recurrent ischemic events (recurrent MI, hospitalization with unstable angina pectoris, or cardiac death) were recorded during a mean follow-up of 13 years. RESULTS: A reduced risk of recurrent events was associated with an upward change of one level (e.g., from 3 at T1 to 4 at T2) in SRH (HR = 0.76, 95%CI: 0.69-0.85), controlling for baseline retrospective SRH. Risk was still significantly lower for each unit of improvement after adjusting for sociodemographics, preevent comorbidity, cardiac risk factors, MI severity, and early post-MI events (HR = 0.85, 95% CI 0.75-0.95). CONCLUSIONS: Individuals who perceived themselves 3-6 months after a first MI to be healthier than they had been in the year preceding the MI were more likely to survive event-free throughout the next 13 years, controlling for baseline retrospective SRH and multiple cardiac risk factors. Failure to experience such subjective recovery of one's health is a serious risk factor, which indicates that SRH should be monitored regularly after a MI.
Authors: Burkhard Schmidt; Adrian Loerbroks; Raphael M Herr; Mark G Wilson; Marc N Jarczok; David Litaker; Daniel Mauss; Jos A Bosch; Joachim E Fischer Journal: Int J Behav Med Date: 2014
Authors: Burkhard Schmidt; Raphael M Herr; Marc N Jarczok; Jens Baumert; Karoline Lukaschek; Rebecca T Emeny; Karl-Heinz Ladwig Journal: Int Arch Occup Environ Health Date: 2018-04-23 Impact factor: 3.015
Authors: Marc N Jarczok; Marcus E Kleber; Julian Koenig; Adrian Loerbroks; Raphael M Herr; Kristina Hoffmann; Joachim E Fischer; Yael Benyamini; Julian F Thayer Journal: PLoS One Date: 2015-02-18 Impact factor: 3.240