Psychological Recovery following Coronary Angioplasty: Illness Cognitions, Coping and Well-being

Aim: To investigate the nature of psychological adjustment following angioplasty and to assess the relative contributions of illness cognitions and coping in the context of the Self-Regulation Model (Leventhal, Meyer & Nerenz, 1980). Design: A longitudinal, prospective within-groups, multi-factorial study. Method: 120 participants were recruited from an opportunity sample of patients approached during admission to the Manchester Heart Centre for angioplasty. Questionnaires addressing illness beliefs, coping and psychological outcomes were presented at two time points; during admission and three months post-procedure. Results: Analysis revealed that angioplasty is followed by clinically and statistically significant psychological gains. Perceptions of the illness as serious, and having a cyclical time-course, together with a general difficulty in making sense of the illness, were associated with increased anxiety at the time of treatment, and in most cases also at three months. Higher levels of emotional representation were also strongly associated with anxiety and quality of life outcomes at both time points. Problem-focused and maladaptive coping also showed associations with psychological outcome at treatment and at three months. Illness beliefs were demonstrated to significantly predict psychological well-being, explaining a substantial proportion of variance, with emotional representation the strongest independent predictor. Coping was not found to mediate the relationship between illness beliefs, and psychological distress and quality of life. Conclusion: This research has demonstrated the utility of illness beliefs, and to an extent the Self Regulation Model in predicting psychological outcome in angioplasty. Cognitive factors may therefore serve as useful clinical indicators to help identity those patients at greatest risk of impaired recovery, which in the future may enable targeting with further support, and evidence permitting, psychological interventions. [Abstract taken from Section B: Research Report (Option 1)]