French David P, Cooper Alethea, Weinman John
School of Sport and Exercise Sciences, University of Birmingham, Birmingham, UK.
J Psychosom Res. 2006 Dec;61(6):757-67. doi: 10.1016/j.jpsychores.2006.07.029.
Early reports indicated that the illness perceptions of patients following acute myocardial infarction (AMI) predict attendance at cardiac rehabilitation. However, null findings have subsequently been reported, and there is variation between studies in terms of which illness perception constructs predict attendance. The aim of this meta-analysis was to examine whether illness perceptions really predict attendance at cardiac rehabilitation and to examine factors that moderate this relationship.
The strategy and procedures recommended by Hunter and Schmidt [Hunter JE, Schmidt FL. Methods of meta-analysis: correcting error and bias in research findings. Thousand Oaks (CA): Sage, 2004] were followed. Based on a systematic literature search, eight studies (N=906 patients) that examined the relationship between illness perceptions and attendance at cardiac rehabilitation were included.
Four illness perception constructs significantly predicted attendance at cardiac rehabilitation: patients with more positive identity (r=.123), cure/control (r=.111), consequences (r=.081), and coherence (r=-.160) beliefs were more likely to attend cardiac rehabilitation. For all relationships, except that between cure/control beliefs and rehabilitation attendance, there was significant heterogeneity, which was attributable to two studies: one that assessed illness perceptions after leaving the hospital yielded higher effect size estimates, whereas another that involved an intervention yielded effect size estimates in the direction opposite to those of most other studies. The exclusion of these studies resulted in largely unchanged, but homogeneous, effect size estimates.
Illness perceptions of AMI patients predict attendance at cardiac rehabilitation, although the effect sizes are small and often heterogeneous. AMI patients who view their condition as controllable, as symptomatic, and with severe consequences, and who feel that they understand their condition are more likely to attend.
早期报告表明，急性心肌梗死（AMI）患者的疾病认知可预测其心脏康复治疗的参与情况。然而，随后有研究报告了阴性结果，且在哪些疾病认知结构可预测参与情况方面，各研究存在差异。本荟萃分析的目的是检验疾病认知是否真的能预测心脏康复治疗的参与情况，并探究调节这种关系的因素。
遵循Hunter和Schmidt[Hunter JE, Schmidt FL. 荟萃分析方法：纠正研究结果中的误差和偏差。千橡树（加利福尼亚州）：Sage出版社，2004年]推荐的策略和程序。基于系统的文献检索，纳入了八项研究（N = 906名患者），这些研究考察了疾病认知与心脏康复治疗参与情况之间的关系。
四种疾病认知结构显著预测了心脏康复治疗的参与情况：具有更积极的身份认同（r = 0.123）、治愈/控制（r = 0.111）、后果（r = 0.081）和连贯性（r = -0.160）信念的患者更有可能参与心脏康复治疗。对于所有关系，除了治愈/控制信念与康复治疗参与情况之间的关系外，均存在显著异质性，这可归因于两项研究：一项在出院后评估疾病认知，其效应量估计值较高，而另一项涉及干预措施的研究，其效应量估计值方向与大多数其他研究相反。排除这些研究后，效应量估计值基本未变，但具有同质性。
AMI患者的疾病认知可预测其心脏康复治疗的参与情况，尽管效应量较小且往往存在异质性。认为自己的病情可控、有症状且后果严重以及觉得自己了解病情的AMI患者更有可能参与治疗。
