Does it matter what patients think? The relationship between changes in patients' beliefs about angina and their psychological and functional status

British Heart Foundation Care and Education Research Group, Department of Health Sciences, University of York, York, UK.
Journal of Psychosomatic Research (Impact Factor: 2.74). 12/2005; 59(5):323-9. DOI: 10.1016/j.jpsychores.2005.06.071
Source: PubMed


The aim of this study is to examine the association between changes in misconceived or maladaptive beliefs about angina and patients' functional and psychological status.
The method used was a prospective follow-up study over 1 year of 133 people with angina.
Beliefs about angina were significantly associated with functional and psychological status. People with more misconceived or maladaptive beliefs were more anxious and physically limited than were people with fewer such beliefs, with differences in physical functioning that were clinically significant. Change in angina beliefs over 1 year was the most significant predictor for physical functioning at follow-up, after controlling for the effects of demographic variables and the outcome variable at baseline, whereas change in the frequency of angina did not contribute significantly to this model.
Misconceived and maladaptive beliefs about angina are associated with reductions in both functional and psychological status. These beliefs are easily and quickly identified using a simple questionnaire and should be corrected.

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    • "of common angina misconceptions that have been found to predict poor outcome (Furze et al. 2005), • Risk factors (smoking status assessed by self-report and Bedfont carbon monoxide breath monitor, serum cholesterol , BP, BMI) and self-rated activity level [derived from the minimum dataset of the UK National Audit for Cardiac Rehabilitation (NACR) (Lewin et al. 2004)]. "
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    ABSTRACT: furze g., cox h., morton v., chuang l.-h., lewin r.j.p., nelson p., carty r., norris h., patel n. & elton p. (2012) Randomized controlled trial of a lay-facilitated angina management programme. Journal of Advanced Nursing68(10), 2267–2279. Aims. This article reports a randomized controlled trial of lay-facilitated angina management (registered trial acronym: LAMP). Background. Previously, a nurse-facilitated angina programme was shown to reduce angina while increasing physical activity, however most people with angina do not receive a cardiac rehabilitation or self-management programme. Lay people are increasingly being trained to facilitate self-management programmes. Design. A randomized controlled trial comparing a lay-facilitated angina management programme with routine care from an angina nurse specialist. Methods. Participants with new stable angina were randomized to the angina management programme (intervention: 70 participants) or advice from an angina nurse specialist (control: 72 participants). Primary outcome was angina frequency at 6 months; secondary outcomes at 3 and 6 months included: risk factors, physical functioning, anxiety, depression, angina misconceptions and cost utility. Follow-up was complete in March 2009. Analysis was by intention-to-treat; blind to group allocation. Results. There was no important difference in angina frequency at 6 months. Secondary outcomes, assessed by either linear or logistic regression models, demonstrated important differences favouring the intervention group, at 3 months for: Anxiety, angina misconceptions and for exercise report; and at 6 months for: Anxiety; Depression; and angina misconceptions. The intervention was considered cost-effective. Conclusion. The angina management programme produced some superior benefits when compared to advice from a specialist nurse.
    Journal of Advanced Nursing 01/2012; 68(10):2267-2279. DOI:10.1111/j.1365-2648.2011.05920.x · 1.74 Impact Factor
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    • "The strength of the relationships was only medium sized, but underlines the existing data confirming the impact of illness beliefs on health-related outcomes [15] [22] [33]. However, in our study, illness beliefs were assessed prospectively before the scheduled cardiac surgery. "
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    ABSTRACT: The purpose of this study was to examine the influence of patients' presurgery illness beliefs and cardiac risk factors on health-related outcomes 3 months following cardiac surgery. In a prospective design, 56 patients undergoing elective cardiac surgery (coronary artery bypass grafting (CABG), heart valve surgery, or a combined procedure) were approached on admission to hospital and reassessed 3 months after surgery. Presurgery assessment included cardiac risk factors and measures of illness severity. Illness beliefs were assessed using the Illness Perception Questionnaire-Revised (IPQ-R). Outcome measures included levels of illness-related disability, physical functioning, psychological well-being, and depressive symptoms. Physical functioning of patients improved 3 months after surgery, while disability and psychological well-being did not change significantly. Cardiac risk factors prior to surgery were unrelated to the outcomes 3 months later. With the use of hierarchical multiple regression analyses, after controlling for demographic variables and baseline scores of outcome variables, patients' beliefs about their illness predicted disability (adjusted R(2)=.350, P<.01), physical functioning (adjusted R(2)=.283, P<.01), and depressive symptoms (adjusted R(2)=.302, P<.01). Illness severity measures did not mediate the association between illness beliefs and outcomes. Patients' beliefs about their illness before surgery strongly influence recovery from cardiac surgery. The results suggest that patients could benefit from presurgery cognitive interventions aimed at changing maladaptive illness beliefs to improve physical functioning and disability following cardiac surgery.
    Journal of psychosomatic research 06/2010; 68(6):553-60. DOI:10.1016/j.jpsychores.2009.10.004 · 2.74 Impact Factor
    • "A number of studies demonstrate a link between negative perceptions and poor outcome in people with CHD. For example, Furze et al. (2005) demonstrated that maladaptive beliefs about angina were associated with poor functional and psychological outcomes. Furthermore, Petrie et al. (1996) discovered that the illness perceptions of people with MI during hospitalization were statistically significant predictors of return to work, functional ability at home and recreational and social activity, with negative perceptions predicting poor outcome. "
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    ABSTRACT: This paper is a report of a systematic review of randomized controlled trials of interventions to change maladaptive illness beliefs in people with coronary heart disease, and was conducted to determine whether such interventions were effective in changing maladaptive beliefs, and to assess any consequent change in coping and outcome. An increasing body of evidence suggests that faulty beliefs can lead to maladaptive behaviours and, in turn, to poor outcomes. However, the effectiveness of interventions to change such faulty illness beliefs in people with coronary heart disease is unknown. Multiple data bases were searched using a systematic search strategy. In addition, reference lists of included papers were checked and key authors in the field contacted. The systematic review included randomized controlled trials with adults of any age with a diagnosis of coronary heart disease and an intervention aimed at changing cardiac beliefs. The primary outcome measured was change in beliefs about coronary heart disease. Thirteen trials met the inclusion criteria. Owing to the heterogeneity of these studies, quantitative synthesis was not practicable. Descriptive synthesis of the results suggested that cognitive behavioural and counselling/education interventions can be effective in changing beliefs. The effects of changing beliefs on behavioural, functional and psychological outcomes remain unclear. While some interventions may be effective in changing beliefs in people with coronary heart disease, the effect of these changes on outcome is not clear. Further high quality research is required before firmer guidance can be given to clinicians on the most effective method to dispel cardiac misconceptions.
    Journal of Advanced Nursing 05/2010; 66(5):946-61. DOI:10.1111/j.1365-2648.2010.05306.x · 1.74 Impact Factor
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