Illness perceptions or recurrence risk perceptions: What comes first? A longitudinal cross-lagged examination among cardiac patients

Abstract

Objectives: Previous research suggested that illness perceptions provide the basis for illness risk perceptions through an inductive reasoning process. This study aimed to assess the direction of relationships between illness and recurrence risk perceptions over time, among cardiac patients.

Design: A longitudinal study was conducted among 138 patients undergoing coronary angioplasty. Self-report questionnaires measured perceived recurrence risk and illness perceptions one day and one month after catheterisation.

Results: Cross-lagged Panel Model Analyses revealed that higher perceptions of timeline, consequences and emotional representations of illness at hospitalisation were associated with higher recurrence risk perceptions one month later. Perceived personal control was the only illness perception with bi-directional associations: higher perceived personal control at hospitalisation was associated with higher recurrence risk perceptions one month later; and higher recurrence risk perceptions at hospitalisation was associated with lower personal control one month later.

Conclusions: The findings suggest that the associations between recurrence risk and illness perceptions can only partly be explained by inductive reasoning. Halo effects and defensive processes are suggested as complementary explanations for the observed associations between risk and illness perceptions.

Keywords:

• illness perceptions
• recurrence risk perceptions
• heart disease
• cross-lagged analysis

Acknowledgements

The data were collected in partial fulfilment of the PhD degree requirements of E.D. at Tel Aviv University, Tel Aviv, Israel. We thank Dr. Yigal Abramowitz for his valuable comments, the staff and patients at the Department of Cardiology for their cooperation and Yasmin Alkalay for her assistance with statistical analyses.

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

1. The excluded items were chance or bad luck, poor medical care in the past, pollution in the environment, accident or injury, altered immunity, a germ or virus, and alcohol.