Illness Beliefs and Emotion Predict the Perceived Necessity of Cardiac Rehabilitation Over Time

Background: Cardiac rehabilitation (CR) is highly effective in promoting physical and psychological recovery following acute cardiac syndrome (ACS). Despite this in the UK, only 42% of eligible patients take part. This study examines determinants of “perceived necessity” of Phase 3 CR in a cohort of ACS patients followed from discharge until the start of CR. Methods: Of 488 eligible ACS patients (March 2012 to July 2013), 214 consented. Consecutive patients completed a computerised weekly diary using shortened standardised questionnaires targeting illness and treatment-related beliefs, mood and “perceived necessity” of CR. Findings: 184 participants provided 5weeks of diary entries. “Perceived necessity” was independently predicted by illness perceptions (“treatment control” (B=0.07, p<.002); “emotional representation” (B= -0.13, p<.001)), treatment perceptions (“concerns regarding exercise” (z=-0.12, p<.001)) and positive affect (z=0.31, p<.001). Discussion: Perceptions of high controllability, negative emotional consequences of ACS, low concern regarding exercise were strong predictors of “perceived necessity”. Targeting these processes could increase attendance at CR.