Importance of illness beliefs and self-efficacy for patients with coronary heart disease

Abstract

Aim: This paper is a report of a study to assess the association between coronary heart disease patients' illness beliefs and their self-efficacy 3 years after hospital discharge.

Background: Cardiac rehabilitation guidelines recommend that both the illness representation model and the concept of self-efficacy are relevant frameworks for developing effective psychological support, although little is known about what aspects of patients' illness beliefs influence their self-efficacy.

Method: In a longitudinal prospective survey, consecutive patients with coronary heart disease were asked to complete questionnaires measuring illness perceptions; self-efficacy and demographic, illness characteristics; and attendance at a cardiac rehabilitation programme. The questionnaire was completed three times between 2001 and 2005. The response rates were 84% at time 1, 77% at time 2 and 72% at time 3. Multiple regression analysis was used to assess the association between illness beliefs and self-efficacy. The data were collected between 2001 and 2005.

Findings: The average age of the participants was 65 years, 79% were male, 50% had acute myocardial infarction, 50% had angina and 61% had no previous history of cardiac illness; 55% had been admitted as an emergency and 57% subsequently attended cardiac rehabilitation. At baseline 30% of the variance in the exercise self-efficacy at 3 years after index admission was accounted for by patients' view of their illness being long-term. Data collected 9 months after discharge showed similar findings.

Conclusion: Early interventions designed to address individuals' sense of control, beliefs about the length of illness and the management of perceived symptoms before hospital discharge could increase rehabilitation programmes effectiveness in sustaining patients' long-term lifestyle changes.