Although there is good evidence that cardiac rehabilitation is effective in improving health outcomes, little is known about the psychological changes that may contribute to these outcomes. This study describes changes in cognition, emotion, behaviour, and health following cardiac rehabilitation and investigates predictors of health outcome and healthy behaviour. Sixty-two people were followed up 2 months after the end of a cardiac rehabilitation programme and 29 people were followed up for 8 months. Compared with before the programme, patients showed increased perceived control over their illness, more confidence in their ability to change their eating habits, and decreased anxiety and depression at both 2 and 8 months after the end of the programme. The increase in perceived control, predicted anxiety and depression 2 months after the course and increased confidence in change predicted better mental health 8 months after. The decrease in depression predicted lower anxiety at 8 weeks and lower anxiety, depression and better mental health at 8 months. The decrease in anxiety predicted lower depression at 8 weeks and lower anxiety, depression, and a trend towards better physical health at 8 months. These results suggest that changing health cognitions after myocardial infarction may reduce distress and this may have long-term benefits for physical health.

Aims: Problem drinkers are reported to take an average of nine years to seek specialist alcohol treatment after recognizing they have a problem. We undertook an in-depth qualitative study to better understand why this delay occurred. Methods: In-depth semi-structured interviews with problem drinkers with varying levels of treatment experience (N = 19). The data were analysed using thematic analysis. Findings: The resolution of drinking-related interference on a number of life domains emerged as the primary motivator for seeking help. These domains included social relationships, living conditions, criminality, poor health and social stigma. Where there was an absence of interference, treatment seeking behaviour was delayed. However, the influence of these domains was not always consistent; a delay influence for one individual sometimes acted as a help-seeking influence for another. The help-seeking pathway for many of these individuals was highly iterative and experience of receiving professional help often occurred before they had accepted that help was needed. Conclusion: Problem drinkers primarily sought help to alleviate psychosocial, health and situational problems rather than to stop drinking per se. The findings highlight the challenges of engaging these individuals in professional support and the wider benefits of further understanding treatment seeking pathways for early problem detection and treatment

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The psychological care of patients at the haemodialysis unit is becoming an increasingly important aspect of the overall treatment of patients with end-stage renal failure. As more is understood and reported regarding the impact of psychological factors on physical processes it becomes crucial that good quality psychological care is delivered to patients by nurses working at the haemodialysis unit. This study aimed to look at haemodialysis patients' perceptions of their treatment to discover if a dialysis centre in Southern England might benefit from a more formal system of psychological care. The data revealed four main themes that were of particular importance to the participants of this study: The New Self, Coping, Medical Concerns and Psychological Care. Within these areas of importance, the need for good quality information, the need for a suitable dialysis environment and the importance of social and family support were evident. Although the psychological care system that was in place at the unit appeared to be working well a more formal system of care might improve the patient experience.

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Rheumatoid arthritis is rarely seen as a serious public health issue, yet it is the single largest cause of disability in the UK (Badley and Tennant 1993). In this qualitative study patients were interviewed about the physical and social effects of the disease.