Cardiac patient and spouse illness representations as mediators in the relationship between affect and well-being

Abstract

Background: Positive and negative affect has often been related to patients’ well-being. Affect seems to convey important information regarding the person/environment interaction and thus may affect perception and behavior and, through these, well-being. The aim of this study was to examine whether illness representations mediate the relation of positive and negative affect to quality of life in a sample of cardiac patients. Also, given the crucial role of patients’ partners in adaptation to illness, a further aim was to examine this indirect relationship at a dyadic level (i.e., patient and spouse). Methods: One hundred and four cardiac patients (25% women) and their spouses participated in the study. Affect was assessed three times at 15-day intervals so as to form a better picture of each person’s recent overall emotional state. Illness representations of control and consequences were assessed two months later, and quality of life four months later. Dyadic responses were examined with the actor–partner interdependence mediation model. Findings: After controlling for couple and illness related factors, patients’ positive and negative affect was related to both partners’ physical and psychological quality of life, but only through patient illness representations. Spouses’ positive and negative affect was associated with both partners’ quality of life through their own and also patients’ illness representations. Discussion: These results highlight the interplay between patient and partner self-regulation process. They also emphasize the role of both partners’ illness representations as a mediator between their interaction with the environment, as depicted by affect, and quality of life.