McGee, H.M., Royal College of Surgeons In Ireland, Ireland
Psychological contributions to understanding and maximising recovery from events such as myocardial infarction are overviewed. Cognitive processes such as illness representations and self-efficacy can help to understand and change perceptions of the meaning of cardiac events. These can be positively influenced by management of social processes such as affiliation through stressful procedures. The independent role of negative affect, in particular, depression and more recently type D, in increasing mortality risk has been documented. On the more positive side, there has been study of the restoration of quality of life following cardiac events through cardiac rehabilitation. Cardiac events signal a chronic condition. Secondary prevention becomes a priority of clinical management. Models of health behaviour change are increasingly used to achieve success in changing a wide range of behaviours associated with chronic conditions. These models illustrate that challenges in primary and secondary prevention of heart disease are the same and have helped in the growing development of this appreciation in clinical medicine. This is fostering new alliances to address the overall challenge of disease. The potential contribution of Psychology to these challenges is evident and the goal is to maximise that contribution in the years ahead.