Illness representation after acute myocardial infarction: impact on in-hospital recovery.
BACKGROUND
Despite significant progress in the treatment of coronary artery disease, myocardial infarction is still the leading cause of death in the United States. As suggested by Leventhal's Self-Regulation Model of Illness, the continued high morbidity and mortality may be due to a failure to address the role of psychosocial factors such as illness representation, depression, and anxiety in recovery.


OBJECTIVE
To determine the relationship between illness representation of myocardial infarction and the occurrence of in-hospital complications and if anxiety and depression mediate this relationship.


METHODS
A prospective correlational design was used to measure illness representation, depression, and anxiety 24 to 48 hours after admission for myocardial infarction in 49 patients and the frequency of complications during the acute event. Logistic regression was used to determine the likelihood of experiencing a complication.


RESULTS
When demographic and clinical variables were controlled for, the more negative the representation of illness, the greater were the odds of experiencing a complication (chi2 = 16.9, df = 6, P =.01). The odds of experiencing a complication increased 5.1% for each 1 unit increase in the score on the Illness Preparation Questionnaire (B = 0.05, Wald = 4.442, Exp(B) = 1.051, 95% CI = 1.003-1.1010). Neither anxiety (chi2 = 3.0, df = 1, P =. 09) nor depression (chi2 = 2.5, df = 1, P = .11) were significant predictors of the occurrence of complications.


CONCLUSIONS
In these patients, illness representation was predictive of the likelihood of experiencing a complication. Thus, illness representation appears to be an important psychosocial factor in acute recovery from myocardial infarction.
Cherrington
Candace C
CC
College of Nursing and Health, Wright State University-Miami Valley, Dayton, Ohio, USA.
Moser
Debra K
DK
Lennie
Terry A
TA
Kennedy
Carol W
CW
D000223:Adaptation, Psychological; D001007:Anxiety / Q000503:physiopathology / Q000523:psychology; D001294:Attitude to Health; D003863:Depression / Q000503:physiopathology / Q000523:psychology; D005260:Female; D006801:Humans; D016013:Likelihood Functions; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D009203:Myocardial Infarction / Q000150:complications* / Q000523:psychology*; D009820:Ohio; D011237:Predictive Value of Tests; D011446:Prospective Studies; D020127:Recovery of Function / Q000502:physiology*; D011795:Surveys and Questionnaires