UBC Theses and Dissertations
The role of a community-based cardiac education program for post-myocardial infarction patients Weir, Catherine J.
This exploratory study examined the role of a community-based cardiac education program for post-myocardial infarction patients in affecting their health knowledge, health beliefs, and health behaviors. Four sources of data were used to address this purpose: components of both a hospital and a community-based program, Home Care nurses, and post-myocardial infarction patients. The framework for the study was the PRECEDE-PROCEED health promotion planning model (Green & Kreuter, 1991), serving as an organizational framework for instrument development and data analysis. In addition, it provided the conceptual basis for understanding the context in which education is offered, and ways in which the program addressed factors within that context. Analysis of the hospital program was done to determine the baseline level of cardiac education provided to patients before hospital discharge. Both programs were analyzed in relation to philosophical framework, content, implementation, and evaluation. A questionnaire addressed Home Care nurses' perceptions of the intended and unintended outcomes of the Home Care Program. An interview schedule was administered to first-myocardial infarction patients, to determine health behaviors, health knowledge, health beliefs, and perception of both programs. This interview schedule was used both for the in-hospital interview, and a follow-up interview at six to eight weeks post-discharge. A qualitative approach to data analysis enabled exploration of emergent themes within and across data sources. Conclusions of the study related to themes identified through the qualitative approach and included the following: 1. The primary difference between the Hospital and Home Care Program related to method of implementation; a standardized versus an interactive, individualized approach; 2. Predisposing factors, such as beliefs, motivation, and culture were of major significance in adoption of recommended behavior changes; 3. Cultural factors played an important role in the social context of the patient and family, thus affecting other antecedents to behavior; 4. The environment in which the education was offered was a key element in determining the effect of the program on promoting behavior and lifestyle change.
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