ROLE OF PATIENTS VIEW OF THEIR ILLNESS IN PREDICTING RETURN TO WORK AND FUNCTIONING AFTER MYOCARDIAL-INFARCTION - LONGITUDINAL-STUDY

Objective-To examine whether patients' initial perceptions of their my ocardial infarction predict subsequent attendance at a cardiac rehabil itation course, return to work, disability, and sexual dysfunction. De sign-Patients' perceptions of their illness were measured at admission with their first myocardial infarction and at follow up three and six months later.Setting-Two large teaching hospitals in Auckland, New Ze aland. Subjects-143 consecutive patients aged under 65 with their firs t myocardial infarction. Main outcome measures-Attendance at rehabilit ation course; time before returning to work; measures of disability wi th sickness impact profile questionnaire for sleep and rest, social in teraction, recreational activity, and home management; and sexual dysf unction. Results-Attendance at the rehabilitation course was significa ntly related to a stronger belief during admission that the illness co uld be cured or controlled (t=2.08, P=0.04), Return to work within six weeks was significantly predicted by the perception that the illness would last a short time (t=-2.52, P=0.01) and have less grave conseque nces for the patient (t=-2.87, P=0.005), Patients' belief that their h eart disease would have serious consequences was significantly related to later disability in work around the house, recreational activities , and social interaction, A strong illness identity was significantly related to greater sexual dysfunction at both three and six months. Co nclusions-Patients' initial perceptions of illness are important deter minants of different aspects of recovery after myocardial infarction, Specific illness perceptions need to be identified at an early stage a s a basis for optimising outcomes from rehabilitation programmes.