The Impact of Illness Perception in Cardiopulmonary Rehabilitation Patients: An Exploratory Study in Rural Eastern North Carolina

Abstract

Background: Cardiovascular and pulmonary rehabilitation (CVPR) is an underutilized resource that can aid in recovery from cardiovascular events and improve health related quality of life in pulmonary patients. Illness perception, which refers to how a patient views and understands their disease state, appears to have a role in the attendance and completion of CVPR. The current study investigated the relationship between illness perception and attendance and completion of CVPR, 6-minute walk test (6MWT) performance, and experience of depression and/or anxiety. Methods: The present study used a longitudinal design that followed CVPR patients who were taking part in an intervention study which aimed to increase engagement in values-based health behavior change over 5-weeks. Participants completed baseline and follow-up measures of illness perception, depression, and anxiety, along with ecological momentary assessment (EMA) of illness perception on days which they were scheduled to attend CVPR. Demographic data and 6MWT scores were derived from the CVPR registry database. Results: Results suggested that illness perception was not a significant predictor of CVPR absence (p=0.532) or completion (p=0.502) in this sample. Illness perception was associated with baseline 6MWT performance (p=0.004) and baseline 6MWT performance was associated (p=0.006) with more threatening follow-up illness perception for participants that completed the study. The relationship between baseline illness perception and discharge 6MWT was also evaluated for participants that completed CVPR, however, the relationship was not statistically significant (p=0.141). Finally, illness perception was significantly positively associated with baseline experience of both depressive (p[less-than]0.001) and anxious symptoms (p[less-than]0.001). Conclusion: Results from this study suggested that there is a significant association between illness perception and both 6MWT and affective state, but not between illness perception and attendance and completion of the CVPR program. The study was novel in that it was conducted in a rural southeastern United States sample and in that it included a sample with heterogeneous disease states. Further research is needed to evaluate possible interventions addressing illness perception and to further investigate the relationship between illness perception and 6MWT performance.