title: Educational level, coping, and psychological and physical aspects of quality of life in heart transplant candidates.
abstract: OBJECTIVE
  To determine whether demographic factors and coping strategies are related to quality of life in heart transplant candidates.
  
  
  METHODS
  Participants were 50 inpatients being evaluated for heart transplant. Coping was measured using the COPE Inventory (1) (J Pers Soc Psychol, 56, 1989, 267). Quality of life was assessed using the SF-36 (2) (Health Survey: Manual and Interpretation Guide, Quality Metric Inc, Lincoln, RI, 2000).
  
  
  RESULTS
  Higher education and less seeking of social support were independently associated with better physical functioning. Higher use of denial was associated with poorer mental health functioning.
  
  
  CONCLUSIONS
  In patients with significant physical limitations, years of education appears to be protective. Less seeking of social support was associated with better physical functioning perhaps because individuals who feel better physically do not feel the need to elicit support. Alternatively, the tendency to not seek assistance could stem from personality characteristics such as avoidance or optimism. Denial was associated with worse mental health functioning. Denying the existence of a stressor may be a high risk coping strategy for patients who are pre-transplant and even more dangerous for those who are post-transplant given the need to be alert to symptoms. Proactive identification of patients at risk for poorer quality of life will allow for more timely psychosocial interventions, which could impact post-transplant outcomes.
authors.affiliation: Department of Allied Health Sciences, CB#7205, Medical School Wing E, University of North Carolina, Chapel Hill, NC 27599-7205, USA. eburker@med.unc.edu
authors.forename: Eileen J
authors.initials: EJ
authors.lastname: Burker
authors.forename: Alok
authors.initials: A
authors.lastname: Madan
authors.forename: Donna
authors.initials: D
authors.lastname: Evon
authors.forename: Jerry B
authors.initials: JB
authors.lastname: Finkel
authors.forename: Michael R
authors.initials: MR
authors.lastname: Mill
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology*; D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000368:Aged; D001362:Avoidance Learning; D003863:Depression; D004522:Educational Status; D005260:Female; D006304:Health Status; D016027:Heart Transplantation / Q000523:psychology* / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology*; D012959:Socioeconomic Factors; D055815:Young Adult