The present research considers the relationship between family members' perceptions of the adjustment required following the medical diagnosis of chest pain and their own subsequent levels of psychosocial adjustment and quality of life. Comparisons are made between responses of patient groups with chest pain of cardiac origin and of non-cardiac origin and their spouses. A control group is also included;Further consideration is given to the associations among variables which may affect the basic relationship between groups and their subsequent adaptation. The effects of health beliefs, stress accumulation, and individual and family resources on the basic relationship are examined;Data resulted from a 1986 study of 456 subjects at Marshalltown Family Medical Services, P.C., in Marshalltown, Iowa;Results of the present study showed that the non-cardiac patient and spouse groups reported significantly higher levels of adjustment to illness and lowest levels of life satisfaction. Although the cardiac patient and spouse groups reported the most life satisfaction, they showed poorest adjustment in occupational, marital, sexual, and recreational areas;The cardiac and non-cardiac patient groups functioned least well psychologically and had most problems with restlessness, time pressures, anger, and low self-esteem. The cardiac patient spouse group, however, reported most life change secondary to the chest pain of the patient. Positive health attitudes, self-efficacy, and adaptability contributed to more successful adjustment. Life event stressors were important to illness groups, but were not important for adjustment to illness or life satisfaction for the healthier controls.