Coronary heart disease patients' perception of their symptoms and sense of control are associated with their quality of life three years following hospital discharge.

BACKGROUND: Recent intervention studies have attempted to address cardiac rehabilitation patients' illness beliefs to improve care. Their findings were mainly limited to short-term behaviour changes such as return to work or attendance on rehabilitation programmes. Evidence about what aspects of the patients' illness beliefs influence long-term quality of life in cardiac rehabilitation remains sparse.

OBJECTIVE: To examine the association between coronary heart disease patients' illness beliefs and their quality of life three years after hospital discharge.

DESIGN: A longitudinal prospective survey.

METHODS: Coronary heart disease patients (n = 253) completed validated questionnaires at three points. Patients' illness beliefs were measured twice: before hospital discharge and nine months after discharge - using the Illness Perception Questionnaire. Quality of life was assessed as the outcome measure at three years after discharge, using the Health Survey SF36v2 questionnaire. Demographic, illness characteristics and cardiac rehabilitation attendance were also assessed.

RESULTS: Two multiple regression analyses were performed with each of the SF36v2 physical and mental health summary scores as outcome variables. Analysis of baseline data showed 43% of the variance in the physical health summary score at three years was accounted for by a perceived lower number of symptoms, belief that the illness was controllable, admission as an emergency and no previous history of cardiac illness; 22% of the variance in the mental health summary score was accounted for by perceived lower number of symptoms and no previous history of cardiac illness. Repeat analysis using the data collected nine months after discharge showed similar findings.

CONCLUSION: Coronary heart disease patients' perception of their symptoms and sense of control at time of discharge were significantly associated with their quality of life three years after discharge.

RELEVANCE TO CLINICAL PRACTICE: This study promotes the use of the assessment of patients' illness beliefs as a routine practice to improve care.