Personality and Appointment-Keeping Adherence in Cardiac Rehabilitation

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Abstract
Literature reviews typically have concluded that personality factors are unrelated to adherence to treatment programs, including adherence to exercise prescribed in cardiac rehabilitation. This study constitutes a reconsideration of this conclusion. Using the California Psychological Inventory (CPI), a well-validated inventory of general personality tendencies, personality variables, and appointment-keeping in cardiac rehabilitation were examined. Forty-nine men entering a cardiac rehabilitation program completed the CPI. Exercise capacity was measured on entry into the 4-month phase II/III program and at completion. Adherence indicators were appointment-keeping and completion or non-completion of the program. General appointment-keeping and hospital admissions during the subsequent year were tracked. Appointment-keeping accounted for 35% of the variance in posttreatment exercise capacity, controlling for pretreatment exercise capacity. Scores on the CPI scales that were significantly related to appointment-keeping were Well-Being (perception of physical/emotional health), Socialization (acceptance of rules and regulations), and Communality (view of self as similar to others). These correlations ranged from 0.49 to 0.38. Those who completed the program (n = 39) had higher scores than those who did not (n = 10) on nearly all of the CPI scales. The differences were significant on the Socialization and Good Impression scales (desire for others to have a favorable impression of oneself). The Socialization score was correlated with keeping appointments in the follow-up year. Personality variables were associated with appointment-keeping adherence. The consistency of our results with those of other recent studies of personality and adherence is discussed, along with implications for cardiac rehabilitation.