Knowledge and expectations: Perceived illness in myocardial infarction patients

In a study of 367 patients with myocardial infarction (MI), questionnaires were developed to assess two central aspects of perceived illness: factual and consensual illness knowledge and subjective expectations for the personal consequences of the MI. In a factor analysis, these two aspects of perceived illness were found to load on separate factors, and the patients views of the personal consequences of the MI were only moderately associated with their general cardiac health knowledge. Among a series of sociodemographic, medical, and psychological variables, including a standardized in-hospital patient education programme, the two aspects of perceived illness also proved to have different determinants. Differences in factual and consensual illness knowledge were mainly related to differences in formal education, and this aspect of perceived illness was influenced by the standardized education programme. In contrast, differences in subjective expectations were associated with levels of hopelessness. The implications for psychosocial interventions in the rehabilitation of MI patients are discussed.