A picture of health - myocardial infarction patients' drawings of their hearts and subsequent disability - A longitudinal study

Objective: The aim of this study was to examine whether myocardial infarction (MI) patients' drawings of their hearts predict subsequent return to work, exercise, distress about symptoms and perceptions of recovery at 3 months. Methods: Just prior to hospital discharge, 74 consecutive patients aged under 70 admitted with an acute MI drew pictures of their hearts. Patients' recovery was assessed at 3 months by postal questionnaire. Results: Patients who drew damage on their heart while in the hospital perceived that their heart had recovered less at 3 months (P=.005), that their heart condition would last longer (P=.01) and had lower perceived control over their heart condition (P=.05) than did patients who drew no damage. The amount of damage drawn on the heart was also associated with a slower return to work (r=.37, P<.05). While patients' peak troponin-T in the hospital was associated with the amount of damage drawn (r=.41, P<.001), it was not associated with the speed of return to work or other 3-month outcomes, apart from perceived duration of heart condition (r=.26, P<.05). Conclusion: Patients, drawings of damage on their hearts after a MI predict recovery better than do medical indicators of damage. Drawings offer a simple starting point for doctors to assess patients' ideas when discussing their heart condition and an opportunity to counter negative illness beliefs. (C) 2004 Elsevier Inc. All rights reserved.