Illness perceptions, mood and coping in predicting attendance at cardiac rehabilitation

OBJECTIVE: The aim of this study was to identify psychological variables in poor/non-attendance at cardiac rehabilitation (CR). We investigated whether attenders and poor/non-attenders differed in relation to components of the self-regulatory model and coping, and which of these variables were the best predictors of attendance behaviour. DESIGN: A cross-sectional, between groups design was employed. In contrast with two previous similar studies, participants completed self-report measures shortly before the start date for the CR programme. Univariate and logistic regression analyses were conducted. METHOD: In all, 93 individuals who had been invited to attend CR completed the Illness Perceptions Questionnaire (IPQ), the Hospital Anxiety and Depression Scale (HADS) and the Coping Orientation to Problems Experienced (COPE). Subsequently, 32 participants failed to attend, or dropped out early from, the programme. RESULTS: Attenders differed from poor/non-attenders in that they perceived a greater number of symptoms and consequences of their illness, greater distress, less strong beliefs that their illness had been caused by a germ or virus, and used problem-focused and emotion-focused coping more frequently. The best predictors of poor/non-attendance were lower perceptions of symptoms and controllability/curability of illness, and less frequent use of problem-focused and more frequent use of maladaptive coping strategies. CONCLUSION: Attenders and poor/non-attenders at CR were distinguished by illness representations, distress and usage of coping strategies. The variables found to be the best predictors of attendance could be used to screen those unlikely to attend and to develop interventions for enhancing attendance.