The purposes of this study were: (a) to describe the illness representations of individuals with coronary artery disease (CAD) who had undergone coronary bypass surgery (CABS), (b) to examine the influence of symptom interpretation on other illness representation components, and (c) to determine the effects of illness representations on coping outcomes during the early recovery period. A convenience sample of 71 postoperative patients was interviewed within 72 hours of anticipated hospital discharge. Illness representations were assessed as follows: (a) identity, with the Symptom Interpretation Questionnaire; (b) cause, with the Causal Questionnaire; (c) duration, with a one-item duration measure; and (d) consequences, with the Expectation for Coping Scale and the Severity of Illness Scale. Emotional coping outcomes were assessed with selected subscales of the Profile of Mood States. Follow-up telephone interviews were conducted at 2 and 6 weeks post-discharge to reassess illness perceptions, emotional outcomes, and functional outcomes, using selected subscales of the Sickness Impact Profile. Findings revealed that subjects identified multiple causes for their condition, with heredity, diet, and tension ranked highest. Nearly one-third of subjects reporting at each point identified their CAD as an acute health problem, while approximately half perceived it as a chronic condition. Furthermore, duration perceptions changed across measurement points. Consequence perceptions were found to improve significantly between time of discharge and 2 weeks post-hospitalization. However, there was no correlation between these perceptions and objective indicators of disease severity. The number of reported symptoms decreased over time. The vast majority of subjects interpreted their symptoms as surgery-related at each interview. Thus, inadequate variability precluded accomplishment of the study's second purpose. Coping outcomes were influenced by duration and consequence perceptions, with better outcomes seen in those subjects who perceived CAD as an acute condition or who had more positive views about its consequences. The findings of this study provide a clearer picture of patients' conceptions of CAD following CABS. This information can be used to assist patients in coping with this surgery during the early recovery period. Furthermore, the results provide a beginning basis for the development of educational strategies to enhance this population's understanding of and attitudes toward rehabilitation activities.
