Cardiac rehabilitation: The psychological changes that predict health outcome and healthy behaviour

Although there is good evidence that cardiac rehabilitation is effective in improving health outcomes, little is known about the psychological changes that may contribute to these outcomes. This study describes changes in cognition, emotion, behaviour, and health following cardiac rehabilitation and investigates predictors of health outcome and healthy behaviour. Sixty-two people were followed up 2 months after the end of a cardiac rehabilitation programme and 29 people were followed up for 8 months. Compared with before the programme, patients showed increased perceived control over their illness, more confidence in their ability to change their eating habits, and decreased anxiety and depression at both 2 and 8 months after the end of the programme. The increase in perceived control, predicted anxiety and depression 2 months after the course and increased confidence in change predicted better mental health 8 months after. The decrease in depression predicted lower anxiety at 8 weeks and lower anxiety, depression and better mental health at 8 months. The decrease in anxiety predicted lower depression at 8 weeks and lower anxiety, depression, and a trend towards better physical health at 8 months. These results suggest that changing health cognitions after myocardial infarction may reduce distress and this may have long-term benefits for physical health.