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June 10, 1939

MENTAL ADJUSTMENTS TO HEART DISEASE: THE FACTORS INVOLVED IN DISABILITY

JAMA. 1939;112(23):2384-2385. doi:10.1001/jama.1939.02800230008003

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Abstract

In heart disease, and peculiarly in coronary thrombosis, the comfort and contentment of the patient are largely conditioned by his adjustment to the problems of his livelihood. The factors which determine his disability, partial or complete, temporary or permanent, may be chiefly considered the following:

  1. Physical incapacity as evidenced by congestive or anginal failure, or circulatory disturbances due to abnormal heart rhythms.

  2. The character of the patient's work, which by necessity may keep the manual laborer from being able to carry on his trade.

  3. Fear of heart disease as an incapacitating or fatal ailment. In such fear there is the normal human reaction to an unpredictable menace, but there is often the terror fostered by the gloomy predictions of the patient's medical advisers. In these predictions we recognize too commonly an attempt on the part of the doctor to protect himself if the patient suddenly dies, or

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