The relationships among self-directed learning readiness, self-care agency, and health status in adults four to eight months after myocardial infarction

Date of Award


Degree Type


Degree Name

Doctor of Philosophy (PhD)


Teaching and Leadership


Thomas Valentine


Chronic heart disease, Self-Directed Learning Readiness Scale, Perception of Self-Care Agency Questionnaire, Sickness Impact Profile

Subject Categories



This investigation expanded the study of self-directed learning beyond consideration of individuals confronting the typical demands of adulthood to those facing unusual life demands. The study examined the relationships among self-directed learning readiness, self-care agency, and health status in adults responding to the demands of a common chronic illness--chronic heart disease.

The investigation was structured as an exploratory field study using a correlational design. The sample was composed of 22 adults between the ages of 32 and 65, who had experienced their first myocardial infarction (MI), and been hospitalized in central New York acute care hospitals.

Data analysis with nonparametric statistics considered the relationships among scores obtained on the Self-Directed Learning Readiness Scale (SDLRS) and the Perception of Self-Care Agency Questionnaire (PSCAQ) just prior to hospital discharge and Sickness Impact Profile (SIP) scores obtained four to eight months later. Relationships to selected demographic variables, illness-related characteristics, and illness-related learning behaviors were also examined.

Self-directed learning readiness was found to be unrelated to self-care agency in adults hospitalized after the onset of chronic illness. Scores on the SDLRS were not significantly different from those typically found in healthy adults. Over 70% of the sample engaged in instrumental self-directed learning during the rehabilitation phase. Yet, readiness scores were not found to be significantly related to either instrumental self-directed learning behavior or health status four to eight months after first MI.

Scores on the PSCAQ were significantly lower than those of the norming sample of adults and in general, self-care agency was not found to be significantly related to health status four to eight months after first MI. Those with high self-care agency did have significantly lower levels of work-related dysfunction.

The overall level of dysfunction measured by the SIP was small for the majority of the sample, with greater dysfunction in the psychosocial dimension than in the physiological. Health status did not differ significantly based on severity of infarct or participation in a cardiac rehabilitation program. The level of dysfunction was significantly higher for those who had to be readmitted to the hospital during the rehabilitation period.


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