Heart failure patients' illness representations and attitudes towards medication in a specialist nursing intervention

Objectives: To examine the impact of a specialist nursing intervention upon the illness representations, self-reported medication adherence, attitudes towards medication and psychological morbidity of heart failure patients. Design: A longitudinal study following a cohort of community based participants who had been previously hospitalised with heart failure over a three month time interval. Method: A total of 28 heart failure patients participated in the study. Participants completed a demographic questionnaire, the Illness Perception Questionnaire (IPQ), the Medication Adherence Report Scale (MARS), the Beliefs About Medicines Questionnaire-General Version (BMQ-G), the Beliefs About Medicines Questionnaire-Specific Version (BMQ-S), the Hospital Anxiety and Depression Scale (HADS) and the Significant Others Scale-Form B (SOS-B) at two interviews. Comparisons of data within the group at the two time points were undertaken. Results: Analysis revealed no statistically significant differences within the group from time one to time two of the nursing intervention in illness representation, self reported medication adherence, attitudes towards medication or physiological morbidity. The exception to this was a significant difference on the BMQ-S subscale, necessity. Between time one and time two participants' beliefs in the necessity of their medication had significantly reduced. Conclusions: Whilst specialist nursing interventions have significantly reduced hospital readmissions, no significant psychological impact of this programme was detected. The potential reasons for the lack of significant results as well as the clinical implications of the findings are explored. The value of routine assessment of psychological morbidity in this population is discussed.