coping, exercise and mood. Therefore, they asked the questions ‘Does recovery from
stroke relate to illness cognitions?’ and ‘If so, is this relationship dependent upon other
factors?’ The results showed no support for the mediating effects of coping, exercise and
mood but supported earlier work to indicate a predictive relationship between control
beliefs and recovery.
Predicting recovery from MI
Research has also explored the relationship between illness cognitions and recovery from
MI. From a broad perspective research suggests that beliefs about factors such as the
individual’s work capacity (Maeland and Havik 1987), helplessness towards future MIs
(called ‘cardiac invalidism’) (Riegel 1993) and general psychological factors (Diederiks
et al. 1991) relate to recovery from MI as measured by return to work and general social
and occupational functioning. Using a self-regulatory approach, research has also indi-
cated that illness cognitions relate to recovery. In particular, the Heart Attack Recovery
Project, which was carried out in New Zealand and followed 143 first time heart attack
patients aged 65 or under for 12 months following admission to hospital. All subjects
completed follow-up measures at 3, 6 and 12 months after admission. The results
showed that those patients who believed that their illness had less serious consequences
and would last a shorter time at baseline, were more likely to have returned to work by
six weeks (Petrie et al. 1996). Furthermore, those with beliefs that the illness could be
controlled or cured at baseline predicted attendance at rehabilitation classes (Petrie et al.
1996). In a recent study authors did not only explore the patients beliefs about MI but
also the beliefs of their spouse to ask whether congruence between spouse and patients
beliefs was related to recovery from MI (Figueiras and Weinman 2003). Seventy couples
in which the man had had an MI completed a baseline measure of the illness cognitions
which were correlated with follow-up measures of recovery taken at 3, 6 and 12 months.
The results showed that in couples who had similar positive beliefs about the identity and
consequences of the illness, the patients showed improved recovery in terms of better
psychological and physical functioning, better sexual functioning and lower impact of
the MI on social and recreational activities. In addition, similar beliefs about time line
were related to lower levels of disability and similar cure/control beliefs were associated
with greater dietary changes. Beliefs about illness therefore seem to be associated with
recovery. Further, congruence in beliefs also seems to influence outcomes.
A self-regulatory approach may be useful for describing illness cognitions and
for exploring the relationship between such cognitions and coping, and also for
understanding and predicting other health outcomes.
TO CONCLUDE
In the same way that people have beliefs about health they also have beliefs about illness.
Such beliefs are often called ‘illness cognitions’ or ‘illness representations’. Beliefs about
illness appear to follow a pattern and are made up of: (1) identity (e.g. a diagnosis and
symptoms); (2) consequences (e.g. beliefs about seriousness); (3) time line (e.g. how long
ILLNESS COGNITIONS 71