Comparison of psychologic stress responses in patients and spouses ten weeks after a cardiac illness event.

A stress scale that is brief and easy to administer would be clinically useful to assess patients' and spouses' psychological stress responses to a cardiac illness situation and provide objective data for health care recommendations. The purpose of this study was to: a) develop and test an instrument to evaluate the stress or difficulties associated with the recovery process after a cardiac event; and b) assess the similarities and differences between patients' and spouses' perceptions of stress. Stress was conceptualized to be reflected by two broad dimensions, namely environmental stress and individual stress. A correlational survey design was used to examine patients' (n = 180) and spouses' (n = 168) stress responses 10 weeks after the cardiac event. The findings suggested that the tool demonstrated satisfactory reliability and validity in measuring the patients' but to a lesser extent the spouses' stress responses. The three most significant stresses reported by most patients were uncertainty about if and when the illness might recur, not being able to participate in work or retirement activities, and adopting a low cholesterol diet. For the majority of spouses, the three most significant stresses were uncertainty about the husband's illness, increased demands within the marital relationship, and assuming more family roles. For those individuals trying to quit smoking or who quit immediately prior to the cardiac event, smoking was the most stressful change for patients and the second most stressful for spouses. Educational programs for cardiac patients and spouses need to provide information related to these stresses to offset the potentially adverse impact of stress and promote adjustment.