title: Patient satisfaction with treatment after acute myocardial infarction: role of psychosocial factors.
abstract: OBJECTIVE
  To determine if psychosocial status influences treatment satisfaction, a quality-of-care indicator, of patients who were hospitalized for acute myocardial infarction (AMI).
  
  
  METHODS
  Psychosocial variables (social support, dispositional optimism, and depression) were assessed in 1847 AMI patients who completed a 1-month assessment in Prospective Registry Evaluating Myocardial Infarction: Events and Recovery (PREMIER), a multicenter, prospective cohort study. Patients' treatment satisfaction was determined using the Treatment Satisfaction scale of the Seattle Angina Questionnaire. The association between psychosocial variables and treatment satisfaction-adjusted for site, sociodemographics, medical history, clinical presentation, and treatment procedures-was evaluated using a censored normal model.
  
  
  RESULTS
  Study participants were primarily white (77.6%) and male (68.8%), with a mean age of 60.6 +/- 12.7 (SD) years. Satisfaction with posthospitalization treatment following AMI increased as social support (Wald chi(2) = 35.02, p < .001) and dispositional optimism (beta = 1.42; 95% CI 0.24, 2.60) increased. Participants with mild (-3.10, 95% CI -5.77, -0.44), moderate (-4.77, 95% CI -8.16, -1.38), moderately severe (-8.49, 95% CI -13.47, -3.52), and severe (-11.65, 95% CI -18.77, -4.53) depression had significantly worse treatment satisfaction compared with the nondepressed participants.
  
  
  CONCLUSIONS
  Assessing psychosocial variables, such as social support, dispositional optimism, and depression severity before hospital discharge, may indicate who is likely to be more satisfied with posthospitalization cardiac care 1 month following AMI. Without controlling for psychosocial status, treatment satisfaction may be a biased indicator of quality. Future studies should evaluate whether psychosocial intervention after AMI can improve satisfaction.
authors.affiliation: Department of Internal Medicine/Geriatrics, Yale University School of Medicine, New Haven, CT 06511, USA. lisa.barry@yale.edu
authors.forename: Lisa C
authors.initials: LC
authors.lastname: Barry
authors.forename: Judith H
authors.initials: JH
authors.lastname: Lichtman
authors.forename: John A
authors.initials: JA
authors.lastname: Spertus
authors.forename: John S
authors.initials: JS
authors.lastname: Rumsfeld
authors.forename: Viola
authors.initials: V
authors.lastname: Vaccarino
authors.forename: Philip G
authors.initials: PG
authors.lastname: Jones
authors.forename: Mary E
authors.initials: ME
authors.lastname: Plomondon
authors.forename: Susmita
authors.initials: S
authors.lastname: Parashar
authors.forename: Harlan M
authors.initials: HM
authors.lastname: Krumholz
mesh_terms: D000368:Aged; D001290:Attitude; D003863:Depression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000523:psychology* / Q000628:therapy*; D017060:Patient Satisfaction; D011446:Prospective Studies; D012720:Severity of Illness Index; D012944:Social Support