Causal attributions in patients and spouses following first‐time myocardial infarction and subsequent lifestyle changes

Objectives. To assess causal attributions in first‐time myocardial infarction (MI) patients and their spouses and to relate these attributions to changes in patients' health‐related behaviour at 6 months after the MI. Design. A prospective single cohort design in which baseline attributions were related to health‐related behaviour change at 6 months. Patient and spouse attributions were compared using ANOVA and principal components factor analysis. Both sets of attributions were related to behaviour change using correlation and step‐wise multiple regression analysis. Method. A sample of 143 first‐time MI patients participated in this study. They completed questionnaires assessing their causal attributions and health‐related behaviour during their stay in hospital and at 6 month follow‐up ( N = 115). Spouses ( N = 84) completed the attribution questionnaire at 12 weeks post‐MI. Results. The most commonly endorsed attributions for both groups were ‘stress’, ‘high cholesterol’, and various health risk behaviours. The overall pattern of patient and spouse attributions was broadly similar but the factor analyses revealed some differences in the factor structures of the two sets of attributions. Most MI patients had made significant changes in health behaviour at 6 months, and those who believed that their MI was caused by their poor health habits were more likely to have made dietary changes at 6 months. Spouse attributions to poor health habits were associated with improvements in patients' exercise level at 6 months. Conclusion. The prospective associations between both patient and spouse causal attributions and subsequent changes in health‐related behaviour confirm the importance of specific causal attributions in adjustment to first‐time MI.