Illness beliefs in patients with recurrent symptomatic atrial fibrillation

Background: Atrial fibrillation (AF) is a prevalent condition associated with adverse outcomes that need to be addressed by clinicians. Functional limitations and psychological distress occur in association with AF and may be influenced by patients' illness beliefs. Current knowledge of illness beliefs of AF patients is insufficient to guide interventions to improve clinical outcomes.

Aims: To (1) describe illness beliefs in patients with recurrent symptomatic AF and (2) describe relationships among illness beliefs having implications for self-management.

Methods: Subjects (n = 207), 56% male, 64.2 ± 12.3 years, from an arrhythmia clinic completed the Illness Perception Questionnaire-Revised. Data were analyzed with descriptive statistics and Pearson correlations.

Results: Subjects perceived AF as chronic and unpredictable with serious consequences. Subjects believed psychological factors, age, and heredity caused AF and reported that AF induced worry, anxiety, and depression. Stronger beliefs about AF as cyclic, unpredictable (r = 0.30), having psychological causes, (r = .36), and greater consequences (r = .58) were associated with more negative emotion. Subjects reporting a good understanding of AF, endorsed fewer negative emotions related to AF (r =-0.38) held stronger beliefs that AF was controllable with treatment, (r = 0.33), and appraised AF as less serious with fewer negative consequences, (r =-0. 21).

Conclusions: Relationships between AF illness beliefs and negative emotion suggest assessment of illness beliefs may identify patients at risk for psychological distress. Although relationships between higher perceived understanding of AF, higher control, lower consequence, and negative emotion suggest that interventions to promote patients' understanding of AF may contribute to positive outcomes, further investigation is warranted.