Affective and social-cognitive predictors of behavioural change following first myocardial infarction

Objectives. To assess the utility of measures of affect and social-cognitive variables in predicting risk behaviours for coronary heart disease in post-myocardial infarction (MI) patients. Design. A longitudinal design was adopted with predictor variables measured while participants were in hospital and dependent variables (exercise, alcohol consumption, diet and smoking) measured 3 months following discharge. Method. A random sample of 43 patients with a first MI were identified on the wards and given a questionnaire measuring anxiety and depression, and measures of outcome and self-efficacy expectancies and intentions relevant to each risk behaviour. Thirty-seven participants completed further behavioural measures at 3-month follow-up (excluding those who died in the follow-up period), a 90% completion rate. Results. Social cognition measures were predictive of later behaviour, and in particular light exercise. Here, intentions accounted for 51% of the variance in behaviour explained after partialling out pre-MI levels of exercise. Affect was less predictive, explaining only 7% of the variance in light exercise. Conclusions. Beliefs and intentions about future risk behaviour are formulated in the immediate post-infarct ion period. Future rehabilitation programmes would benefit from some intervention, probably educational, at this early stage.