Causal attributions in patients and spouses following first-time myocardial infarction and subsequent lifestyle changes

Objectives. To assess causal attributions in first-time myocardial infarcti on (MI) patients and their spouses and to relate these attributions to chan ges in patients' health-related behaviour at 6 months after the MI. Design. A prospective single cohort design in which baseline attributions w ere related to health-related behaviour change at 6 months, patient and spo use attributions were compared using ANOVA and principal components factor analysis. Both sets of attributions were related to behaviour change using correlation and step-wise multiple regression analysis. Method. A sample of 143 first-time MI patients participated in this study. They completed questionnaires assessing their causal attributions and healt h-related behaviour during their stay in hospital and at 6 month follow-up (N = 115). Spouses (N = 84) completed the attribution questionnaire at 12 w eeks post-MI. Results. The most commonly endorsed attributions for both groups were 'stre ss', 'high cholesterol', and various health risk behaviours. The overall pa ttern of patient and spouse attributions was broadly similar but the factor analyses revealed some differences in the factor structures of the two set s of attributions. Most MI patients had made significant changes in health behaviour at 6 months, and those who believed that their MI was caused by t heir poor health habits were more likely to have made dietary changes at 6 months. Spouse attributions to poor health habits were associated with impr ovements in patients' exercise level at 6 months. Conclusion. The prospective associations between both patient and spouse ca usal attributions and subsequent changes in health-related behaviour confir m the importance of specific causal attributions in adjustment to first-tim e MI.