Irrational Health Beliefs Predict Adherence to Cardiac Rehabilitation: A Pilot Study

Objective: Cardiac rehabilitation (CR) is routinely prescribed for patients with cardiovascular disease (CVD), but data indicate that 20% to 50% of patients do not adhere to CR. Studies have focused on the impact of depression on CR adherence, but results have been equivocal. Irrational health beliefs are related to adherence among diabetes patients, but have not been examined among cardiac patients. This study examined depression and irrational health beliefs as predictors of CR adherence. Method: Sixty-one participants (30% female; mean age = 59.9 +/- 11.8; 72% Caucasian), recruited at the outset of an outpatient CR program, completed a baseline questionnaire including measures of depression and irrational health beliefs. CR adherence was defined as the percentage of CR exercise sessions completed. Pearson correlations and analysis of variance determined demographic factors related to adherence. Hierarchical regression analyses examined irrational health beliefs and depression as predictors of CR adherence. Results: Older age (p < .05) and higher income (p < .05) were associated with better CR adherence, but CR adherence was lower among African Americans than Caucasians (p < .01). Depression was not related to adherence (p = .78), but irrational health beliefs predicted CR adherence, after controlling for race/ethnicity, income, and age (beta = -.290, Delta R-2 = .074, Delta F[1,55] = 5.50, p < .05). Conclusions: Irrational health beliefs predicted CR adherence but depression did not. Thus, poorer adherence to CR was associated with endorsing beliefs that are not based in medical evidence.