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Objective: To investigate whether a brief in-hospital illness perception intervention for myocardial infarction (MI) patients and their spouses could change spouses' illness perceptions and reduce spouses' anxiety about the illness., Methods: Fifty-seven spouses participated in a randomized controlled trial of an illness perception intervention for MI patients. Spouses of patients randomized to the intervention attended one half-hour patient-and-spouse session with a psychologist in addition to standard care. Spouses completed measures of illness perceptions, expectations, and illness anxiety at admission and at 1 week following discharge, and spouses' illness worry was rated by the patients at 3 months. The main outcome for spouses was differences in anxiety between intervention and control groups., Results: One week following discharge, spouses in the intervention group had higher illness understanding, lower concern, stronger causal attributions to hereditary factors, and fewer questions about their partner's heart condition compared to the control group. Intervention group spouses reported more positive expectations about the ability of the patient's heart to recover, and lower perceived likelihood of another MI. They had lower anxiety about the patient doing physical activity and about the patient's medications, and lower distress about the patient's symptoms. Spouses in the intervention group were rated as less worried about the illness at 3 months., Conclusion: Spouses of patients represent a new target for illness perception interventions and these results demonstrate that a brief illness perception intervention can change illness perceptions and reduce anxiety about the illness in spouses of MI patients.

Objective: To further develop and trial a brief in-hospital illness perception intervention for myocardial infarction (MI) patients., Methods: One hundred and three patients admitted with acute MI were randomized to receive either standard care or standard care plus an illness perception intervention, which consisted of three half-hour patient sessions and one half-hour patient-and-spouse session delivered in hospital. Patients were followed up to 6 months. The main outcome was the difference between groups in rate of return to work., Results: The intervention group had a faster rate of return to work than the control group, and more patients in the intervention group had returned to full time work by 3 months than in the control group. At discharge, patients in the intervention group demonstrated changes in causal attributions regarding their MI and higher perceived understanding of their condition, which remained at the 6-month follow-up. They also reported a better understanding of the information given in hospital, higher intentions to attend cardiac rehabilitation classes, lower anxiety about returning to work, greater increases in exercise, and made fewer phone calls to their general practitioner about their heart condition at follow-up., Conclusion: This study replicates the findings of an earlier trial that a brief in-hospital illness perception intervention can change perceptions and improve rates of return to work in MI patients. It increases the generalizability of the intervention to the current broader definition of MI and to patients who have had previous infarcts.

Objective: The objective of this study was to investigate how changes in heart attack patients' drawings of their heart over the recovery period relate to psychological and functional recovery., Methods: Sixty-nine inpatients admitted for acute myocardial infarction at the coronary care unit at a metropolitan hospital completed questionnaires at discharge, including a drawing of what they thought had happened to their heart after their heart attack. Fifty-six patients returned follow-up questionnaires at 3 and 6 months, including heart drawings, cardiac anxiety, time to return to work, changes in exercise frequency, and healthcare use., Results: Increases in the size of the heart drawn at the 3-month follow-up relative to discharge were related to slower return to work (r = 0.48, p < .01), higher cardiac anxiety (r = 0.35, p < .05), and more phone calls to health services (r = 0.37, p < .05) as well as increases in worry about another myocardial infarction (r = 0.39, p < .01), increased activity restriction (r = 0.34, p < .05), higher use of alternative medicines (r = 0.40, p < .05), and less frequent exercise (r = -0.39, p < .05) relative to before the myocardial infarction., Conclusions: Drawings of the heart may be useful in identifying patients who have experienced heart attacks who are likely to develop greater heart-focused anxiety, complaints of ill health, and higher use of health care. Increases in the size of the patient's drawing of the heart may reflect increases in the extent to which their heart condition plays on their mind and directs their daily activities.

Background: Accurate perceptions of future cardiac risk are important to ensure informed treatment choices and lifestyle adaptation in patients following myocardial infarction (MI). The aim of this study was to investigate whether risk perceptions of patients with MI were accurate compared with an established clinical risk model., Methods: Seventy-nine consecutive patients with acute MI admitted to the Coronary Care Unit, Auckland Hospital, completed a questionnaire assessing risk perceptions. Clinical data were used to calculate patients' Thrombolysis In Myocardial Infarction (TIMI) risk scores, a validated predictive model of prognosis. The main outcome measures were the associations between perceived risk, TIMI risk scores and troponin T., Results: Patients' risk perceptions showed no correlation with thrombolysis in myocardial infarction risk scores (r = -0.06; P = 0.61) or with troponin T (r = -0.07; P = 0.53). Patients' risk perceptions were not significantly associated with age or sex, and were not significantly higher in those who had experienced a previous MI, a family history of coronary heart disease, diabetes or smokers. Higher perceived risk was significantly associated with a number of illness perceptions, including worse consequences of the MI and lower beliefs in the benefit of treatment. Patients who overestimated their risk were more anxious than other patients (F(2, 73) = 22.97; P = 0.0001)., Conclusion: Patients with MI ideas about their personal risk of future MI are not congruent with their clinical risk assessments. Inpatient hospital care appears to be unsuccessful in communicating prognosis effectively to patients. Improving the accuracy of risk perceptions may help decrease unnecessary cardiac anxiety and invalidism in some patients and prompt risk-reducing behaviours in others.

Objective: The aim of this study was to examine whether myocardial infarction (MI) patients' drawings of their hearts predict subsequent return to work, exercise, distress about symptoms and perceptions of recovery at 3 months., Methods: Just prior to hospital discharge, 74 consecutive patients aged under 70 admitted with an acute MI drew pictures of their hearts. Patients' recovery was assessed at 3 months by postal questionnaire., Results: Patients who drew damage on their heart while in the hospital perceived that their heart had recovered less at 3 months (P = .005), that their heart condition would last longer (P = .01) and had lower perceived control over their heart condition (P = .05) than did patients who drew no damage. The amount of damage drawn on the heart was also associated with a slower return to work (r = .37, P < .05). While patients' peak troponin-T in the hospital was associated with the amount of damage drawn (r = .41, P < .001), it was not associated with the speed of return to work or other 3-month outcomes, apart from perceived duration of heart condition (r = .26, P < .05)., Conclusion: Patients drawings of damage on their hearts after a MI predict recovery better than do medical indicators of damage. Drawings offer a simple starting point for doctors to assess patients' ideas when discussing their heart condition and an opportunity to counter illness negative beliefs.

The article discusses research on the impacts of psychological functioning on the illness perception of patients suffering from discoid lupus erythematosus (DLE). Topics covered include self-regulation of illness, use of the Brief Illness Perception Questionaire, and objective measurement of disease. Also mentioned are the findings on the patient's risk of developing depression.