title: Marital quality and loneliness as predictors for subjective health status in cardiac rehabilitation patients following percutaneous coronary intervention.
abstract: Low marital quality is associated with adverse health outcomes and lower personal well-being. Loneliness increases the risk of cardiovascular disease and mortality and predicts poor quality of life. The aim of this study was to investigate the association between marital quality and loneliness and subjective health status in primary percutaneous coronary intervention (pPCI) patients who underwent cardiac rehabilitation (CR).
  
  
  
  In a prospective cohort study, pPCI patients that followed CR were included between 2009-2011. A total of 223 patients responded to the Short Form 12 (SF-12) (subjective health status), Maudsley Marital Questionnaire (MMQ-6) (marital quality) and University of California, Los Angeles - Revised (UCLA-R) questionnaires at baseline (pre-CR) and at three months (post-CR) or at 12 months follow-up. Subjective health status is displayed by a physical component summary (PCS) score and a mental component summary (MCS) score. Generalized estimating equation (GEE) analyses were performed to test improvements in subjective health status.
  
  
  
  Changes over time in subjective health status scores were similar between patients with optimal marital quality vs patients with less optimal marital quality and non-lonely patients vs lonely patients. The MCS level at one-year follow-up of both patients with less optimal marital quality and lonely patients was lower compared with a healthy Dutch population (respectively; mean MCS score 47.3 (standard deviation (SD) 10.5); p = 0.013 and mean MCS score 46.1 (SD 11.2); p = 0.010).
  
  
  
  Both patients with less optimal marital quality and lonely patients did not reach the MCS level of a healthy Dutch population. Therefore, extra care and support should be given to these patients in a CR programme.
authors.affiliation: Department of Cardiology, Thoraxcenter Erasmus Medical Centre, The Netherlands.
authors.forename: Joost
authors.initials: J
authors.lastname: Roijers
authors.affiliation: Capri Cardiac Rehabilitation, The Netherlands.
authors.forename: Madoka
authors.initials: M
authors.lastname: Sunamura
authors.affiliation: Department of Child and Adolescent Psychiatry/Psychology, Erasmus Medical Centre, The Netherlands.
authors.forename: Elisabeth Mwj
authors.initials: EM
authors.lastname: Utens
authors.affiliation: Department of Child and Adolescent Psychiatry/Psychology, Erasmus Medical Centre, The Netherlands.
authors.forename: Karolijn
authors.initials: K
authors.lastname: Dulfer
authors.affiliation: Capri Cardiac Rehabilitation, The Netherlands Department of Rehabilitation Medicine, Erasmus Medical Centre, The Netherlands.
authors.forename: Nienke
authors.initials: N
authors.lastname: Ter Hoeve
authors.affiliation: Capri Cardiac Rehabilitation, The Netherlands Department of Rehabilitation Medicine, Erasmus Medical Centre, The Netherlands.
authors.forename: Myrna
authors.initials: M
authors.lastname: van Geffen
authors.affiliation: Department of Cardiology, Thoraxcenter Erasmus Medical Centre, The Netherlands.
authors.forename: Jan
authors.initials: J
authors.lastname: Draaijer
authors.affiliation: Department of Cardiology, Thoraxcenter Erasmus Medical Centre, The Netherlands.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Steenaard
authors.affiliation: Department of Cardiology, Thoraxcenter Erasmus Medical Centre, The Netherlands r.vandomburg@erasmusmc.nl.
authors.forename: Ron T
authors.initials: RT
authors.lastname: van Domburg
mesh_terms: D000072038:Cardiac Rehabilitation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D008132:Loneliness / Q000523:psychology*; D008297:Male; D017533:Marital Status; D008603:Mental Health; D008875:Middle Aged; D009203:Myocardial Infarction / Q000523:psychology / Q000534:rehabilitation* / Q000601:surgery; D062645:Percutaneous Coronary Intervention / Q000523:psychology / Q000534:rehabilitation*; D011184:Postoperative Period; D011446:Prospective Studies; D011788:Quality of Life; D011795:Surveys and Questionnaires; D013997:Time Factors
keywords: Percutaneous coronary intervention; cardiac rehabilitation; loneliness; marital quality; subjective health status