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Illness behaviour and outcome following survived myocardial infarction

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Patterns of illness behaviour were examined in 120 survivors of acute myocardial infarction (MI) between 10 and 14 days after their admission to a coronary care unit. Factor analysis of these data revealed 8 orthogonal dimensions which have been reported previously [1]. Factor score profiles were constructed for each patient to represent the degree to which specified dimensions of illness behaviour were characteristic of individual patient responses. All patients were followed up 8 months after discharge from hospital, either by personal interview and examination for those surviving this period, or by consulting death certificates and medical records for those who had died in the intervening period. Information on cardiological outcome and occupational rehabilitation were sought for survivors, while cause of death was ascertained for non-survivors. Rates of recurrent MI (survived or otherwise) and return to work were consistent with expectations arising from previous studies. Several aspects of illness behaviour evident soon after MI were also found to be predictive of outcome. Those with poor cardiological outcomes at 8 months were more likely than others to have expressed concern about somatic functioning and recognition of contributory life stress soon after the initial MI. Those failing to return to work at 8 months were more likely than others to have accepted the sick role and expressed subjective feelings of tension following the initial MI.

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Journal of Psychosomatic Research

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