Goals in cardiac rehabilitation: influencing factors, relation to outcome, and relevance of physicians' illness perception.

Purpose: The study attempted to identify and define subgroups of patients participating in cardiac rehabilitation (CR) whose CR goal profiles were similar, what factors influence the definition of targets for these goals, and how the definition of goals influenced the short-term and medium-term effects of CR.

Methods: Data were obtained from 2,182 patients participating in 17 CR centers in Germany from 2001 to 2003. The data collection instruments included a patient questionnaire on general health status and a case report form completed by a physician.

Results: A latent class analysis led to a 3-cluster solution including a patient cluster of "risk factor patients" for whom the CR goals were primarily reduction of blood pressure and cholesterol level; a patient cluster of "multimorbidity patients" with numerous interdisciplinary CR goals; and a patient cluster for which the goals were relatively undefined. These clusters were derived only from the analysis of the CR goals defined by physicians rather than from the analysis of the baseline health status. Goal setting in the psychologic area was greater than 1.5 times more likely to occur for men than for women. The setting of goals had no independent influence on the effects of CR.

Conclusion: Findings suggest that the cognitive illness perception of the treating physician affects goal setting in CR.