Is patient involvement during hospitalization for acute myocardial infarction associated with post-discharge treatment outcome? An exploratory study.

摘要

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. DESIGN: Self-administered questionnaire study. Questionnaire results were run against medical outcome data in a national database of cardiac patients. SETTING AND PARTICIPANTS: Cardiac patients (n = 591) on their first follow-up visit after hospitalization for MI at 11 Swedish hospitals. MAIN OUTCOME MEASURES: 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. CONCLUSION: 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.