Health anxiety, mental defeat and fear of illness recurrence and progression following a cardiac event: Implications for cardiac rehabilitation.

OBJECTIVES: To evaluate the contribution of health anxiety, mental defeat and fear of recurrence and progression (FRP) as variables in the adjustment process following cardiac events and subsequent wellbeing, adjustment and rehabilitation. DESIGN: A two-part study was conducted: cross-sectionally examining psychological factors shortly following a cardiac event and longitudinally examining how these variables were associated with adherence and physical/psychological outcomes of cardiac rehabilitation. METHODS: A UK-based sample of post-cardiac event patients (N = 176, Mage = 66.1, SD = 10.0) was categorized as high health anxiety with depression and/or anxiety, depression or anxiety only, or neither health anxiety nor depression/anxiety. Mental defeat and FRP were compared across groups pre-rehabilitation and examined in relation to adherence to, and outcomes of, an 8-session cardiac rehabilitation programme. RESULTS: Analyses indicated significantly higher mental defeat and FRP in those with health anxiety than in the other groups. However, regression analyses showed that neither health anxiety, mental defeat, nor FRP was significantly associated with rehabilitation adherence or outcomes. CONCLUSIONS: This study identified mental defeat and FRP as important factors in health-anxious cardiac patients, with implications for the coping and adjustment process and rehabilitative efforts. No linear association between these variables and rehabilitation adherence and outcomes was found, suggesting that more nuanced approaches to identifying their impact on rehabilitation may require development.