Abstract
Background: Men and women differ in anxiety, which is one of the most stressful outcomes of an acute myocardial infarction (AMI). This anxiety may be moderated by coping styles of preference for information and control.
Objective: This study aimed to examine the relation of gender and preference for information and control to anxiety during the critical care period after AMI.
Methods: As part of a larger study on complications after AMI, a descriptive cross-sectional multicenter one-group investigation designed with a convenience sample of AMI patients admitted to acute care units was conducted. Within the first 48 hours after the patients were admitted to the hospital, anxiety was assessed using the State Anxiety Inventory, and preference for information and control was measured using the Krantz Health Opinion Survey.
Results: The sample of AMI patients (N = 410) was 68% male, 87% White, 68% married. The women were significantly older than the men (p < .05) and significantly more anxious (p < .05). Multiple stepwise regression analysis with a control for age demonstrated that neither preference for information nor preference for control moderated the relation of gender and anxiety.
Conclusions: The women expressed greater anxiety than the men. However, the men and women were similar at all levels of anxiety in their preference for information and control. The search for other factors related to the stress of AMI will help healthcare providers design effective interventions to reduce anxiety among men and women.
When patients experience an acute myocardial infarction (AMI), individual differences in coping may substantially affect the outcomes of this stressful event. As compared with men, women experience AMI at an older age, are more anxious at the time of AMI, and experience more severe limitations after AMI. Men and women may vary in the way they cope, particularly in the extent to which they want information about their illnesses and the extent to which they want to be in control and involved in treatment decisions (Benbassat, Pilpel, & Tidbar, 1998). Research should determine how nurses can tailor interventions to individual preferences. This is essential to better assistance for patient coping to improve cardiac outcomes. This study examines how gender and anxiety are associated with patients' preferences for information and control in the critical care setting after an AMI.
Anxiety is the most common response to the stress of an AMI. It is among the earliest and most intense of the psychological responses that affect morbidity and mortality after AMI (Berkman, Leo-Summers, & Horowitz, 1992;Frasure-Smith, Lesperance, & Talajic, 1995). Patients with acute myocardial infarction who had high anxiety levels during the critical care period were five times more likely than patients with lower anxiety levels to experience in-hospital complications of recurrent ischemia, reinfarction, and ventricular tachycardia/fibrillation (Moser & Dracup, 1995). This association persisted even after control was used for traditional risk factors (e.g., prior cardiac history, age, left ventricular ejection fraction). Healthcare providers should identify factors associated with high anxiety to facilitate effective coping in response to the stressful event of an AMI (Pierce & Hicks, 2001). Knowledge about gender, the preference for information and control, and their relation to anxiety will assist clinicians in their care during the critical period after AMI.
Preference for information is a tendency to report the use of information seeking as a primary or predominant coping strategy (Garvin & Kim, 2000;Krantz, Baum, & Wideman, 1980). Preference for control is a tendency to report the use of behavioral involvement in healthcare as a predominant coping strategy (Krantz et al., 1980;Wallston, Wallston, Forsberg, & King, 1984).
Preference for control is distinguished from perceived control, the "belief" that one can influence internal and external states and achieve desired outcomes (Wallston et al., 1984). For example, a person may have a high preference for control but perceive that he or she has no control in the coronary care unit. Patients vary in their desire to become involved in healthcare decisions (Pierce & Hicks, 2001).