Is patient involvement during hospitalization for acute myocardial infarction associated with post-discharge treatment outcome? An exploratory study.
OBJECTIVE
To investigate whether patient involvement during hospitalization for acute myocardial infarction (MI) was associated with health and behavioural outcomes 6-10 weeks after hospital discharge.


BACKGROUND
Patient involvement has been associated with improved health outcomes in chronic disease, but less research has focused on the effects of patient involvement in acute conditions, such as MI.


METHODS
Self-administered questionnaire study. Questionnaire results were run against medical outcome data in a national database of cardiac patients.


METHODS
Cardiac patients (n = 591) on their first follow-up visit after hospitalization for MI at 11 Swedish hospitals.


METHODS
Patient ratings of three questionnaire scales related to involvement; cardiovascular symptoms, medication compliance, participation in cardiac rehabilitation, and achievement of secondary preventive goals.


RESULTS
More positive patient ratings of involvement were significantly associated with fewer cardiovascular symptoms 6-10 weeks after hospital discharge. In contrast, patients who attended cardiac rehabilitation and achieved the goals for smoking cessation and systolic blood pressure were significantly less satisfied with their involvement. No association was found between involvement ratings and medication compliance.


CONCLUSIONS
This study represents a first attempt to examine associations between patient involvement in the acute phase of illness and short-term health outcomes. Some significant associations between involvement and health and behavioural outcomes after acute MI were found. However, higher involvement ratings were not consistently associated with more desirable outcomes, and involvement during hospitalization was not associated with MI patient health and behaviour 6-10 weeks after hospital discharge to the extent hypothesized.
Arnetz
Judith E
JE
Department of Family Medicine and Public Health Sciences, Division of Occupational and Environmental Health, Wayne State University, Detroit, MI, USA. jarnetz@med.wayne.edu
Winblad
Ulrika
U
Höglund
Anna T
AT
Lindahl
Bertil
B
Spångberg
Kalle
K
Wallentin
Lars
L
Wang
Yun
Y
Ager
Joel
J
Arnetz
Bengt B
BB
D000208:Acute Disease; D000328:Adult; D000368:Aged; D005260:Female; D015438:Health Behavior; D006801:Humans; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000628:therapy*; D010347:Patient Care Planning / Q000706:statistics & numerical data; D010349:Patient Compliance / Q000706:statistics & numerical data; D010351:Patient Discharge / Q000706:statistics & numerical data*; D010353:Patient Education as Topic; D010358:Patient Participation; D016540:Smoking Cessation / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D016896:Treatment Outcome