title: The influence of non-modifiable illness perceptions on attendance at cardiac rehabilitation.
abstract: BACKGROUND
  Despite the established benefits of cardiac rehabilitation (CR) attendance rates remain variable. Physical barriers to attendance have been extensively investigated but relatively less is known about the relationship between attendance at CR and psychosocial variables such as illness perceptions and social isolation.
  
  
  OBJECTIVE
  To examine the influence of socio-demographic factors, illness perceptions and social isolation on patient attendance at cardiac rehabilitation.
  
  
  METHODS
  All individuals offered CR over a two-year period were invited to take part in a postal survey. The survey collected socio-demographic data and included completion of the Friendship Scale, to assess social isolation, and the Brief Illness Perceptions Questionnaire. Parametric and non-parametric statistical tests were used as appropriate.
  
  
  RESULTS
  One hundred and twenty-eight (47%) questionnaires were returned. Non-attendees reported higher total illness perception scores and those who attributed their illness to non-modifiable factors were significantly less likely to attend CR (p = 0.042). Attendees reported lower levels of social isolation; however, this finding was not statistically significant. No differences were found between attendees and non-attendees in terms of their age, gender, educational status or proximity to cardiac rehabilitation centre.
  
  
  CONCLUSIONS
  Psychosocial barriers, specifically illness perceptions and attributions, were found to be significant with patients who did not attend CR reporting more negative illness perceptions. Distance to CR was not a significant factor influencing attendance. Early screening of perceived causal attributions may help to identify those who would benefit from early and targeted intervention to increase participation in CR. Future prospective studies would permit testing of screening approaches and early interventions.
authors: 1School of Nursing and Midwifery, University of Stirling, Inverness, UK.
authors: Julie
authors: J
authors: Blair
authors: Neil J
authors: NJ
authors: Angus
authors: William J
authors: WJ
authors: Lauder
authors: Iain
authors: I
authors: Atherton
authors: Josie
authors: J
authors: Evans
authors: Stephen J
authors: SJ
authors: Leslie
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001071:Appointments and Schedules; D001294:Attitude to Health; D064646:Cardiovascular Nursing; D003625:Data Collection; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006331:Heart Diseases / Q000451:nursing / Q000523:psychology / Q000534:rehabilitation; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000523:psychology*; D010465:Perception; D011584:Psychology; D019145:Rehabilitation Nursing; D012189:Retrospective Studies; D012934:Social Isolation / Q000523:psychology; D055815:Young Adult
keywords: Cardiac rehabilitation; barriers; illness attributions; illness perceptions