Randomized controlled trial of an intervention to change cardiac misconceptions in myocardial infarction patients

Abstract

There is converging evidence that changing beliefs about an illness leads to positive recovery outcomes. However, cardiac misconceptions interventions have been investigated mainly in Angina or Coronary Heart Disease patients, and less in patients following Myocardial Infarction (MI). In these patients, cardiac misconceptions may play a role in the adjustment or lifestyle changes. This article reports a randomized controlled trial of an intervention designed to reduce the strength of misconceptions in patients after a first MI. The primary outcome was the degree of change in misconceptions and the secondary outcomes were: exercise, smoking status, return to work and mood (anxiety and depression). Patients in the intervention condition (n = 60) were compared with a control group (n = 67) receiving usual care. Both groups were evaluated at baseline and 4, 8 and 12 months after hospital discharge. There was a significant time-by-group interaction for the total score of cardiac misconceptions. Patients in the intervention group significantly decreased their total score of cardiac misconceptions at 4 months compared with the control group and this difference was sustained over time. Patients in the intervention group were also more likely to exercise at the follow-up period after MI than the control group. This intervention was effective in reducing the strength of cardiac misconceptions in MI patients and had a positive impact on health behaviour outcomes. These results support the importance of misconceptions in health behaviours and the utility of belief change interventions in promoting health in patients with Myocardial Infarction.

Keywords:

• Cardiac misconceptions
• myocardial infarction
• randomised controlled trial
• exercise behaviour
• psychological intervention
• illness beliefs
• cardiac rehabilitation
• self-management

Acknowledgements

The authors would like to acknowledge Professor Manuel Carrageta MD, Professor Gill Furze PhD RN and Prof. John Weinman as consultants of this research project and Carlos Catarino MD for assistance with patient recruitment. The Coronary Care Units at: Hospital Garcia de Orta – Unidade Coronária and Serviço de Cardiologia; Almada, Portugal. Hospital de Santa Maria – UTIC – Arsénio Cordeiro – Maria José Correia MD; Lisboa, Portugal. Hospital de S. Francisco Xavier – UNICARD – Cristina Ferreira MD and Miguel Mendes MD; Lisboa Portugal.