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The Mediating Role of Perceived Control on the Relationship Between Socioeconomic Status and Functional Changes in Older Patients With Coronary Heart Disease

¹ Department of Health Sciences, University Medical Center Groningen, University of Groningen, The Netherlands.
² School for Public Health and Primary Care (CAPHRI), Maastricht University, The Netherlands.

Address correspondence to Professor Adelita V. Ranchor, PhD, Department of Health Sciences – Health Psychology, University Medical Center Groningen, University of Groningen, P.O. Box 196, 9700 AD, Groningen, The Netherlands. E-mail: a.v.ranchor{at}med.umcg.nl

Using a prospective design, this study examines the mediating effect of perceived control in explaining the predictive role of socioeconomic status (SES) in long-term changes in functional status as a consequence of the occurrence of coronary heart disease (CHD). We followed 221 older CHD patients by using a community-based survey. We collected data on patients' functional status before the onset of disease and 1 year after the diagnosis. Multiple linear regressions show that SES predicts functional changes only in relation to physical functioning. Furthermore, self-efficacy, but not mastery, mediates the predictive role of SES in changes in physical functioning in CHD patients. Self-efficacy is the only aspect of control that mediates the relation between SES and changes in physical functioning. Our findings provide a basis for future interventions in disadvantaged groups of older persons and new theoretical models of recovery processes.

Key Words: Socioeconomic status • Coronary heart disease • Functional status • Perceived control • Self-efficacy • Mastery • Aging