cahon M

Regimen compliance two years after myocardial infarction.

Two-years postinfarction, the effect of a nursing intervention at 30 days postinfarction, and intentions, attitudes, and perceived beliefs of others on regimen compliance of myocardial infarction patients was investigated. The sample was comprised of 51 patients (E = 29, C = 22) who participated in a five-phase study over 2 years. No differences were found between experimental and control groups for regimen compliance to activity, stress, and medication prescriptions. The experimental group was significantly more compliant to the diet prescription than the control group. The control group was significantly more compliant than the experimental group with cessation from smoking. Perceived beliefs of others were predictive of compliance for all regimen prescriptions at 2 years. Attitude was also predictive of compliance with the diet, smoking, and stress regimens.

Influence of a Nursing Intervention On Regimen Adherence and Societal Adjustments Postmyocardial Infarction

One hundred three first-time myocardial infarction (MI) patients were randomly assigned to either an experimental or a control condition. Patients completed a cardiac rehabilitation program during hospitalization ad were interviewed to assess intentions to follow regimen prescriptions, attitudes toward the prescriptions, coping methods, and he perceived beliefs of others concerning their intentions. Patients were visited at home 30 days after discharge and reassessed on each of the above variables except that their behavior was substituted for intentions and societal adjustment was assessed. The experimental group was given an intervention program which included a discussion of assessment data, identification of problems, and establishment of goals. The assessment was repeated 60 days after discharge. No differences were found between experimental and control groups for either medical regimen adherence or societal adjustment. There was a significant decrease in mean scores for all variables from hospital to 30 days for both groups, but no change from 30 to 60 days. Attitudes and perceived beliefs of others were predictive of adherence, and it was concluded that these variables need to be included in any rehabilitation program.

Indicators of medical regimen adherence for myocardial infarction patients

This study investigated relationships between demographic and medical variables, attitudes, perceived beliefs of others, and intentions toward medical regimen adherence and actual posthospitalization regimen adherence. During hospitalization, attitudes, perceived beliefs of others, and intentions toward prescribed medical regimen were elicited from 112 persons recovering from a first time myocardial infarction (MI). Six to 9 months posthospitalization, attitudes, perceived beliefs of others, and adherence behaviors were assessed. Multiple regression analysis indicated that, during hospitalization, attitudes and perceived beliefs of others were strong indicators of intentions to adhere to the medical regimen, but they were not indicators of actual adherence posthospitalization. Posthospitalization, attitudes and perceived beliefs of others were strong indicators of actual regimen adherence. Findings indicate rehabilitation plans for the MI patient should be individualized for hospital and home and should include data on health belief variables.

Development of a health attitude scale.

A tool was developed to assess attitudes of patients with cardiac disease toward performing prescribed behaviors of their medical regimen. Two groups of subjects with heart disease were used to examine validity and reliability of the Miller Attitude Scale. One group included 480 members of Mended Hearts, Inc., and the second group consisted of 35 patients diagnosed with a first myocardial infarction. The second group repeated the attitude scale six months post-hospitalization. Performance of the medical regimen by this group was verified at the six-month follow-up period. Using Spearman Rank Correlation, there was a significant relationship between attitudes and adherence behaviors for three of the five subscales. Alpha reliabilities revealed a high degree of internal consistency of scale items for all five subscales when testing both groups.A factor analysis resulted in eight factors accounting for the majority of the variance. Each of the five behaviors of the medical regimen clearly defined a factor supporting use of the Miller Attitude Scale for assessing attitudes of heart patients toward behaviors of their medical regimen.

Stressors and Stress Management 1 Month After Myocardial Infarction

&NA; Stressors and stress management behaviors reported by 52 myocardial infarction (MI) patients were identified from a content analysis of transcriptions of nurse/patient/spouse interactions that took place 30 days postinfarction. Subjects defined stress primarily in terms of distress related to appraisals of harm, loss, or threat. Stressors and stress management behaviors varied, although subjects were similar in age and occupation and were in the same phase of recovery. Most stressors related to recent myocardial infarction and pertained to thoughts and feelings more than to external events. Others, related to family and/or work, were ongoing before the MI. Stress management behaviors comprised a continuum of physical, cognitive, and verbal behaviors ranging from active to passive. Avoidance of situations, ignoring situations, expressing feelings, and thinking things through were the four major modes of stress management behaviors. Implications for rehabilitation nursing practice are identified.

Osteoporosis: Identifying High-Risk Persons

Osteoporosis is the most common systemic bone disorder causing thousands of injuries and deaths each year. The pathogenesis of osteoporosis is a complex puzzle that contains many interlocking pieces involving both genetic and environmental factors. The prevention of age-related bone loss, which could be gained through health teaching by the nurse, should be optimized. Nurses and other caregivers can make significant contributions toward the initial identification of those persons at risk or who may already have the debilitating disease by using the Osteoporosis Risk Questionnaire.