The illness perceptions of patients with percutaneous coronary intervention compared to patients with no percutaneous intervention, for acute myocardial infarction, in cardiac rehabilitation

Abstract

Purpose Patients who receive percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) have been found to have low attendance at cardiac rehabilitation (CR). It has been suggested that this is because PCI patients have a benign perception of their coronary disease; however, this has never been quantitatively investigated. The aim of this prospective study was to evaluate the illness perceptions (IP) of patients with AMI treated with PCI. Methods The Heart Health Illness Perception Questionnaire (modified version of the Brief Illness Perception Questionnaire) and the Cardiac Beliefs Questionnaire were used to assess patients’ IP and cardiac disease misconceptions, respectively. Patients in phase 2 of CR were recruited from the Royal Alexandria Hospital, Paisley, UK. One hundred two patients were identified from the cardiac unit database over a 16-week period and sent questionnaires. Results Fifty-six patients returned questionnaires suitable for analysis (54.9% response rate). There was a significant difference in the IP scores of the 3 groups [primary-PCI (pPCI) = 0.18 ± 1.44, elective-PCI = 5.27 ± 15.65, non-PCI = 9.94 ± 11.19; P = 0.046]. PCI patients had a significantly lower IP score than non-PCI patients (PCI = 1.62 ± 12.76, non-PCI = 9.94 ± 11.19; P = 0.027). pPCI patients had a significantly lower IP score than non-pPCI patients (pPCI = 0.18 ± 11.44, non-pPCI = 8.04 ± 13.11; P = 0.021). Of the PCI patients 22.9% agreed they were ‘fixed for life’ and a lower IP score was found to predict this opinion (P = 0.032). Conclusion PCI patients, particularly pPCI patients, perceive their coronary disease to be relatively benign. Further research is required to investigate if this predicts poor attendance at CR.