Abstract
The two surveys in this study explore the importance of illness perception and self-efficacy with cardiac patients and cardiac rehabilitation practitioners. The main investigation is a prospective longitudinal survey using validated questionnaires completed by 253 patients following their diagnosis of Myocardial Infarction or Angina in hospital and nine months later when the patients are expected to be functioning independently of any rehabilitation programme. The aim of this survey is to examine the predictive values of illness perception components and outcome expectations on self-efficacy measures for patients with coronary heart disease. The study concluded that, following statistical controls for the potential effects of intervening demographic and illness characteristic variables, the illness representation components 'symptom’ and 'control/cure' significantly contribute to cardiac patients' exercise and diet self-efficacy respectively nine months after their initial cardiac event. The second survey explores practitioners' perception of the importance and understanding of patient expectations and their current practice in assessing expectation in cardiac rehabilitation. This exploratory survey involved practitioners from ten hospitals in the south east of England, and used a questionnaire devised from expectancy theory articulated in Bandura’s writings and content analyses of the current cardiac rehabilitation literature. The results of the survey show that cardiac rehabilitation practitioners are very aware of the general importance of patient expectations but have little structured support in the development of techniques to either assess these expectations or to utilise them in a therapeutic context. The findings from the patient survey suggest that an approach can be designed to integrate both the theoretical perspectives of illness perception and self-efficacy to broaden the focus of cardiac rehabilitation practice from an emphasis on the severity of the condition of the patient to address individual patient needs and increase the success of maintaining long-term behaviour changes.