Quality of life can both influence and be an outcome of general health perceptions after heart surgery
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Quality of life can both influence and be an outcome of general health perceptions after heart surgery Lars Mathisen*1,2, Marit H Andersen1,3, Marijke Veenstra4, Astrid K Wahl5, Berit R Hanestad5 and Erik Fosse1 Address: 1The Interventional Centre, Faculty Division Rikshospitalet, Faculty of Medicine, University of Oslo, N-0027 Oslo, Norway, 2Dept of Thoracic and Cardiovascular Surgery, Rikshospitalet-Radiumhospitalet Medical Center, Sognsvannsveien 20, N-0027 Oslo, Norway, 3Dept of Surgery, Rikshospitalet-Radiumhospitalet Medical Center, Sognsvannsveien 20, N-0027 Oslo, Norway, 4Dept. of Biostatistics, RikshospitaletRadiumhospitalet Medical Center, Sognsvannsveien 20, N-0027 Oslo, Norway and 5The Institute of Public Health/Faculty of Social Sciences, University of Bergen, N-5020 Bergen, Norway Email: Lars Mathisen* - [email protected]; Marit H Andersen - [email protected]; Marijke Veenstra - [email protected]; Astrid K Wahl - [email protected]; Berit R Hanestad - [email protected]; Erik Fosse - [email protected] * Corresponding author
Published: 24 May 2007 Health and Quality of Life Outcomes 2007, 5:27
doi:10.1186/1477-7525-5-27
Received: 3 February 2007 Accepted: 24 May 2007
This article is available from: http://www.hqlo.com/content/5/1/27 © 2007 Mathisen et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract Background: Our aim was to investigate the existence of a reciprocal relationship between patients' assessment of quality of life and their appraisal of health. If present, this relationship will interfere with the interpretation of heart surgery's effect on overall quality of life. Methods: Path analysis was used to investigate reciprocal causal relationships between general health perceptions and overall quality of life before and after heart surgery. Longitudinal data from a study of coronary artery bypass surgery were used to model lagged, cross-lagged, and simultaneous paths over four time-points of assessment from before surgery to one year afterwards. The conceptual framework for the analysis was the Wilson and Cleary causal pathway model. General health perceptions were measured with the Short Form 36. Overall quality of life was measured with i) a single question regarding life satisfaction and ii) the multi-item Quality of Life Survey. Results: Acceptable model fit was obtained for reciprocal causation between general health perceptions and overall quality of life. Regression coefficients changed over different phases of rehabilitation. Serial correlation accounted for much of the variance within variables over time. Conclusion: The present analysis demonstrates that unidirectional models of causality are inadequate to explain the effect of heart surgery
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