Illness beliefs before cardiac surgery predict disability, quality of life, and depression 3 months later

J Psychosom Res. 2010 Jun;68(6):553-60. doi: 10.1016/j.jpsychores.2009.10.004. Epub 2009 Dec 5.


Objective: 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.

Methods: 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.

Results: 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.

Conclusion: 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.

MeSH terms

  • Activities of Daily Living / classification
  • Activities of Daily Living / psychology
  • Adult
  • Aged
  • Combined Modality Therapy
  • Comorbidity
  • Coronary Artery Bypass / psychology*
  • Depressive Disorder / diagnosis*
  • Depressive Disorder / psychology*
  • Disability Evaluation*
  • Female
  • Health Status Indicators
  • Heart Valve Prosthesis Implantation / psychology*
  • Humans
  • Illness Behavior*
  • Internal-External Control
  • Judgment*
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Postoperative Complications / diagnosis*
  • Postoperative Complications / psychology*
  • Quality of Life / psychology*
  • Risk Factors
  • Treatment Outcome