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Primary emotions in patients after myocardial infarction


  • Gerald Bowman MPhil RGN RMN,

  • Roger Watson PhD RN FRSA,

  • Anita Trotman-Beasty BA RN

Roger Watson,
The Graduate School of Nursing and Midwifery,
The University of Sheffield,


Aims.  This paper reports a study testing the reliability and validity of the Emotion and Health Scale and to check convergent and discriminant validity against the Hospital Anxiety and Depression Scale.

Background.  Reactions to illness are often measured in the narrow terms of anxiety and depression. Primary emotions are claimed by the functionalist school of psychology to be adaptive and to produce specific behaviours for survival. The functionalist theory requires testing in the context of health threat and adaptation. This paper is concerned with the development of a 24-item self-assessment scale of eight primary emotions.

Methods.  A healthy cohort of 150 university students was enrolled to complete the Health and Emotion Scale. A cohort of 80 first-time myocardial infarction patients was enrolled to complete the Emotion and Health Scale and the Hospital Anxiety and Depression Scale four days after the onset of myocardial infarction or when symptoms were controlled. The data were collected in 2002.

Results.  The Emotion and Health Scale was shown to have acceptable internal consistency. Significant differences were observed between the healthy and myocardial infarction cohorts in illness attributed sadness, anger, disgust and surprise. Healthy men had significantly more health fear than women.

Conclusions.  The Emotion and Health Scale is a valid and reliable instrument that could be used to study emotion and illness. This line of enquiry may improve understanding of illness reactions and the role primary emotions exert on adaptation to health change.