Assessing acute coronary syndrome patients' cardiac-related beliefs, motivation and mood over time to predict non-attendance at cardiac rehabilitation

Aim This research protocol describes and justifies a study to assess patients' cardiac‐related beliefs (i.e. illness representations, knowledge/misconceptions, cardiac treatment beliefs), motivation and mood over time to predict non‐attendance at a cardiac rehabilitation programme by measuring weekly/monthly changes in these key variables. Background Heart disease is the UK's leading cause of death. Evidence from meta‐analyses suggests that cardiac rehabilitation facilitates recovery following acute cardiac events. However, 30–60% of patients do not attend cardiac rehabilitation. There is some evidence from questionnaire studies that a range of potentially modifiable psychological variables including patients' cardiac‐related beliefs, motivation and mood may influence attendance. Design Mixed‐methods. Methods In this study, during 2012–2013, electronic diary data will be gathered weekly/monthly from 240 patients with acute coronary syndrome from discharge from hospital until completion of the cardiac rehabilitation programme. This will identify changes and interactions between key variables over time and their power to predict non‐attendance at cardiac rehabilitation. Data will be analysed to examine the relationship between patients' illness perceptions, cardiac treatment beliefs, knowledge/misconceptions, mood and non‐attendance of the cardiac rehabilitation programme. The qualitative component (face‐to‐face interviews) seeks to explore why patients decide not to attend, not complete or complete the cardiac rehabilitation programme. Discussion The identification of robust predictors of (non‐)attendance is important for the design and delivery of interventions aimed at optimizing cardiac rehabilitation uptake. Funding for the study was granted in February 2011 by the Scottish Government Chief Scientist Office (CZH/4/650).