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American Journal of Critical Care. 2004;13: 136-145
Copyright © 2004 by the American Association of Critical-Care Nurses.
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CE Online

Illness Representation After Acute Myocardial Infarction: Impact On In-Hospital Recovery

By Candace C. Cherrington, RN, PhD, Debra K. Moser, RN, DNSc, Terry A. Lennie, RN, PhD and Carol W. Kennedy, RN, PhD. From College of Nursing and Health, Wright State University-Miami Valley, Dayton, Ohio (CCC), College of Nursing, University of Kentucky, Lexington, Ky (DKM, TAL), and College of Nursing, Ohio State University, Columbus, Ohio (CWK).

• Background Despite significant progress in the treatment of coronary artery disease, myocardial infarction is still the leading cause of death in the United States. As suggested by Leventhal’s Self-Regulation Model of Illness, the continued high morbidity and mortality may be due to a failure to address the role of psychosocial factors such as illness representation, depression, and anxiety in recovery.

• Objective To determine the relationship between illness representation of myocardial infarction and the occurrence of in-hospital complications and if anxiety and depression mediate this relationship.

• Method A prospective correlational design was used to measure illness representation, depression, and anxiety 24 to 48 hours after admission for myocardial infarction in 49 patients and the frequency of complications during the acute event. Logistic regression was used to determine the likelihood of experiencing a complication.

• Results When demographic and clinical variables were controlled for, the more negative the representation of illness, the greater were the odds of experiencing a complication ({chi}2 = 16.9, df = 6, P=.01). The odds of experiencing a complication increased 5.1% for each 1 unit increase in the score on the Illness Preparation Questionnaire (B = 0.05, Wald = 4.442, Exp(B) = 1.051, 95% CI = 1.003–1.1010). Neither anxiety ({chi}2 = 3.0, df = 1, P = .09) nor depression ({chi}2 = 2.5, df = 1, P = .11) were significant predictors of the occurrence of complications.

• Conclusion In these patients, illness representation was predictive of the likelihood of experiencing a complication. Thus, illness representation appears to be an important psychosocial factor in acute recovery from myocardial infarction.

To receive CE credit for this article, visit the American Association of Critical-Care Nurses’ (AACN) Web site at http://www.aacn.org, click on "Education" and select "Continuing Education," or call AACN’s Fax on Demand at (800) 222-6329 and request item No. 1175.




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