Discussion

Abstract

There are three key results that will be discussed. First, in section 4.1, depression emerged as the most important psychosocial risk factor for both mortality and physical functioning in the entire sample, while education mediated the relationship between gender and mortality. The predictive priority of depression over physical functioning was confirmed in a cross-lagged panel design, in which cross-sectional associations and baseline scores were controlled for. Second, section 4.2 showed comparable improvement for both men and women after surgery concerning the mean scores of physical functioning and depression. Third, strain through housework in the early phase of recovery proved to be associated negatively with physical functioning and positively with depression in both men and women. These three results will now be discussed with regard to the baseline health status. In addition, methodological considerations, limitations of the study and clinical implications will be outlined.