| The purpose of this study was to determine the relationship of antecedent factors (age, marital status, employment status, socioeconomic status, and severity of illness) and mediating variables (social support, control over health, and self-esteem) to the quality of life of Jordanian women who have had a myocardial infarction. The theoretical framework that guided this study was the Lazarus and Folkman's cognitive model of stress, coping, and adaptation (1984). Using this cognitive framework, a causal model was developed in which the antecedent factors were hypothesized to indirectly affect quality of life (QOL) through the mediating variables.; The research design consisted of an ex post facto, cross sectional, correlational design to examine the relationship among variables. The sample consisted of 94 Jordanian women who had a myocardial infarction (MI). Data were collected using the Quality of Life Index-Cardiac Version-III, Multidimensional Scale of Perceived Social Support, Multidimensional Health Locus of Control, Self-Esteem Rating Scale, The Dartmouth COOP Charts, and Personal Profile Form. Statistical analysis included descriptive statistics, Pearson's correlation coefficients, and multiple regression analysis.; A multiple regression equation containing all the variables explained 81% of the variance in QOL. Overall, five variables accounted for the majority of the total variance: Social support, control over health, self-esteem, socioeconomic status, and severity of illness. Three of these variables were the mediating variables; Hypothesis 2 was supported. Of the antecedent factors socioeconomic status and severity of illness had a significant indirect effect on QOL through the mediating variables. These two antecedent factors also had an unexpected direct effort on QOL; Hypothesis 1 was supported in part.; The results of this study indicate that self-esteem, a sense of control over health, and social support play a role in determining the perception of QOL of women who have had an MI. These mediating variables either buffered or enhanced the impact of the antecedent factors of socioeconomic status and severity of illness on QOL. Nursing interventions should focus on enhancing and supporting the development of self-esteem. Because socioeconomic status and severity of illness directly affected the mediating variables and directly affected QOL, nurses should assess these variables and consider them when identifying appropriate patient outcomes and interventions. Nurses can use cardiac rehabilitation and health promotion programs to assist women who are physically and financially impaired. Future research should be aimed at identifying other influential variables, with the ultimate goal of developing interventions to aid patients in their efforts to manage living with an MI. |
