Psychosocial outcomes of enhanced external counterpulsation treatment : illness perceptions and psychological wellbeing

Abstract

The portfolio has three parts: Part 1 is a systematic literature review, in which the theoretical, conceptual and empirical literature relating to the relationship between illness perceptions, mood and quality of life in coronary heart disease populations is reviewed. The results of this study provide support that illness perceptions are related to outcomes across CHD populations and disease progression, however the results do not selectively support one particular model. Recommendations are consistent with cardiac rehabilitation guidelines. Further research should focus on the systemic impact of illness perceptions. Part 2 is divided into two empirical papers: Paper 1 utilises a qualitative methodology to explore refractory angina patients' experiences of undergoing EECP, and their lives before and after the treatment. The study adds to existing literature by proposing that the process of undergoing EECP treatment not only leads to physiological improvement, but also effects psychological pathways, through providing hope, establishing a therapeutic relationship and increasing confidence and self-efficacy to confront positive and challenging health-behaviour changes. Paper 2 utilises a quantitative methodology to explore the relationship between illness perceptions, mood and quality of life in chronic refractory angina patients that have undergone EECP treatment. The current study supports constructs from relevant models; the self-regulatory model, theory of planned behaviour and an adapted version of the fear-avoidance model. A possible model demonstrating the process between illness perceptions and outcomes specific for chronic refractory angina patients is proposed. Future research could focus on concomitant interventions to improve physical and psychological outcomes, for example the Angina Plan could be delivered in conjunction with EECP to establish an integrated, multidisciplinary model of care and service delivery. Part 3 comprises the appendices. This includes a reflective statement and supplementary information relevant to all three papers.EThOS - Electronic Theses Online ServiceGBUnited Kingdo