Women's social role quality may be an important factor in their adaptation after heart surgery. Relationships among different dimensions of role quality, physical health, and psychological well-being were examined in 157 midlife and older women who had undergone heart surgery. Overall, older women (n = 89) were similar to younger women (n=68) in physical recovery from heart surgery. Poorer health outcomes were associated with number of health Problems, not age. Women with more health problems and lower subjective health perceptions had lower role quality. Multiple regression analyses indicated that, in general, role quality mediated the effects of physical health on psychological well-being. Regardless of the extent of physical health problems, women with higher role quality had higher levels of psychological well-being. (C) 2002 Wiley Periodicals, Inc.