Quality of life in survivors of myocardial infarction

The concepts of quality of life and health-related quality of life (HRQoL) are wildly used in literature but lack agreed formal definitions. It is however broadly accepted that they are complex, multidimensional, and dynamic constructs, which should be assessed on the basis of positive and negative indicators. The term HRQoL is used to clarify the health-disease context of the analyzed QoL. Both generic and disease-specific instruments are used for HRQoL measurement. Results of the studies on the level and changes in HRQoL after MI are inconsistent. Some studies show HRQoL as being minimally affected by MI, while others indicate major reduction in at least some of its dimensions. Moreover, minor fluctuations to significant changes in HRQoL's different dimensions are reported. The dynamic of these changes varies depending on the period since an MI and between different dimensions of HRQoL. A number of clinical, sociodemographic, and psychosocial characteristics are recognized as predictors of HRQoL in MI survivors. Among sociodemographic characteristics, age, gender, and education are of a special interest with higher education predicting better HRQoL, but age and gender's role being unclear. Among psychosocial resources, e.g., self-esteem and various social resources were recognized as strong predictors of HRQoL, with higher levels of psychosocial resources predicting better HRQoL. More work still needs to be performed to fully understand the dynamics and complexity of quality of life in the context of myocardial infarction and CVD in general. But the results support a need for a comprehensive and patient-centered medical practice.