The illness perceptions of women following acute myocardial infarction: implications for behaviour change and attendance at cardiac rehabilitation.

Coronary heart disease (CHD) has been socially constructed as a gender-specific disease, with women seen not to be at risk (Lockyer, 2002). This is despite CHD being the leading cause of mortality in both men and women in the Western world (DH, 2004). The aim of this research was to explore the illness perceptions of a sample of women following acute myocardial infarction (MI). Relationships between illness perceptions and adoption of health-promoting behaviours, and attendance at a programme of cardiac rehabilitation were explored. The influence of age was also considered. Leventhal and Nerenz' Self- Regulatory Model of Illness Behaviour (1985) was used as the theoretical framework. This model consists of three stages: interpretation of symptoms, coping and appraisal. A qualitative research design was used. A purposeful sample of 10 women was selected on the basis of age and decision to attend cardiac rehabilitation. Data were collected by semi-structured interview, 3 months following the acute infarct, and analysed thematically. Stress was considered to be the cause of the MI, and although lifestyle factors were recognized, their significance was uncertain; perhaps as a result, lifestyle changes were limited. Overall, women had a perceived lack of control over the illness. The decision to attend a cardiac rehabilitation programme was influenced by beliefs relating to the identification of a known cause and level of perceived control of the illness. A belief that the illness was inevitable seemed to be more prevalent in older aged women. These findings have implications for health service providers in that they suggest that illness perceptions need to be explored and addressed before the decision to attend a programme of cardiac rehabilitation is made and health-promoting behaviours adopted.