[Patients' opinions about the reasons for their heart attacks in the context of their health belief models--a preliminary report]

Abstract

The importance of psychological factors in Myocardial Infarction (MI) is well documented. The aim of the study was to define a relationship between the perception of the reasons for MI and real health activity of the sufferers, in order to prepare an adequate psychological intervention. 30 patients after acute MI hospitalized in the Cardiology Department were included to the study. They were questioned in directed interviews. The modified form of Shalit's Circle was used to infer the model of health activity. Perceived reasons for the heart attack (first in 67% cases) appeared as a manifold area, which was divided into eight categories: stressful situations and occurrences (66.67%), an individual's character (40%), lifestyle (36.67%), connected illnesses 36.67%), genetics (20%), age (13.33%), weather (10%), "spontaneous" heart attack (6.67%). The results indicated exterior attribution of MI (e.g. political and economic crisis, innate predisposition, loss of relatives). Similar tendency in the planning of changes after heart attack was observed. For instance 43.33% patients just said they planed to restrict or give up their previous sickness-promoting behaviour, 33.33% talked laconically about "the increase of caution" or "slowing down" and only 26.67% intended to undertake new forms of activity. These opinions illustrate the general model of health beliefs (in declarations and realization), which seems to be of very limited use (or even disadvantageous) with regard to the future. Moreover, the contemporary clinical conditions are conducive to such model. Modern medical methods of treatment reduce the time spent by patients in hospital, thereby reducing the hospitalization stress. On the other hand it limits or even eliminates the most important part of treatment--the "doctor-patient" relationship. Because of the limited number of subjects a further research is needed to combine the psychological intervention aimed at health behaviour change with the high standard of cardiology treatment those patients are being given now. The psychological program should tackle emotional and social costs of heart attack and strive to change patients' health belief system.