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Heart Health

Irrational Health Beliefs & Skipped Cardiac Rehab

Heart patients with beliefs about health that aren’t based on medical evidence are more likely to skip sessions of cardiac rehabilitation, according to a study done at Ohio State Univeristy and available online in April 2014 in the journal Health Psychology and slated to be published in a future print edition.

Among the irrational beliefs assessed were the following:

*Doubting the preventive power of the flu vaccine

*Believing, based on family history alone, that it’s safe to smoke cigarettes and carry excess weight after a doctor’s warning about health risks linked to these behaviors.

Beyond these beliefs, a few demographic factors influenced adherence to a rehabilitation program. On average, older participants and those with higher incomes attended a higher percentage of sessions, while African Americans attended a smaller percentage of sessions than did whites.

Among those factors, African-American patients were more likely than white participants to have a higher number of irrational health beliefs.

A release from the university quotes senior author Charles Emery as saying, “These beliefs about health haven’t been looked at in a cardiac population before. Most patients referred to cardiac rehab have been sedentary. Though they are in a supportive environment, exercise is still not necessarily pleasant and can be painful from time to time. So it’s important to examine factors that might negatively influence them and then intervene to address those factors – in this case, their irrational health beliefs.”

Emery conducted the research with Derek Anderson, lead author and a doctoral candidate in psychology at Ohio State. Improving adherence to a rehabilitation program is critical, Emery said, because cardiac rehab already has strikes against it: Only about a third of eligible patients enter rehabilitation for a variety of reasons, including a low referral rate by cardiologists, insurance limitations, and responsibilities at home and work. This is despite the fact that cardiac rehabilitation lowers the risk of a future heart problem by slowing the progression of disease, according to the American Heart Association.

“In terms of intervening, this study would point the finger at irrational health beliefs as one relevant target. Providing more education and evidence-based medical information to these patients may help enhance adherence,” Emery said. 

The study had a relatively small sample size – 61 participants – but had typical demographics for a cardiac rehab program: A majority (70.5 percent) were men and the group’s average age was almost 60. However, 23 percent of participants were African American, which is a relatively large proportion for studies in this area.

Almost all patients were prescribed a typical 36-session rehab program, with exercise three times per week for one hour plus an hour a week of education about nutrition, stress management and smoking cessation.

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