Causal attributions of patients, their spouses and physicians, and the rehabilitation of the patients after their first myocardial infarction

The possibility that coping with a first myocardial infarction (MI) is mediated by the patient's subjective interpretation of the event was tested in steps. Eighty-nine male patients under the age of sixty, admitted after their first MI to the intensive care unit of the Soroka Medical Center, were interviewed on different occasions within a six-month period. Wives and physicians were similarly interviewed on the same occasions. Five causal patterns were identified among subjects' interpretations of the MI, and were found to be consistent over time and modes of questioning. Patients who attributed the MI and its possible outcomes to external, uncontrollable causes returned to work and to regular physical and sexual functioning after six months at a significantly lower rate than did patients who cited a more complex causal pattern. Wives' attributions and predictions were similar to those of the patients. However, the physicians foresaw the patients' rehabilitation by ascertaining the risk factors (smoking, obesity, hypertension, heredity, etc.), which turned out to be poor indicators of the actual rehabilitation six months later. Theoretic and practical implications of these findings are discussed.