Title

The impact of patient education on physiological and quality of life outcomes in cardiac rehabilitation

Date of Award

5-2002

Degree Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Teaching and Leadership

Advisor(s)

James Bellini

Keywords

Patient education, Physiological, Quality of life, Cardiac rehabilitation

Subject Categories

Educational Assessment, Evaluation, and Research | Public Health Education and Promotion

Abstract

The purpose of this retrospective study was to examine the impact of cardiac education, based on guidelines provided by the American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR), on selected physiological and quality of life outcomes in a Nationally Certified cardiac rehabilitation program.

The first question posed by this investigation was the impact of cardiac education classes on post education test scores. The results of the one-way ANCOVA for cardiac education class attendance and post cardiac education test scores indicated that post cardiac education test scores were significantly different for cardiac attendance groups. The post-hoc Newman-Keuls test indicated that participants who attended the fewest number of education classes also demostrated the lowest percent improvement on the post cardiac education test. In addition, attendance in 2-3 education classes was associated with a significantly higher percent improvement on the post cardiac education test than 0-1 group attendance but a significantly lower percent improvement when compared with those participants who attended 4, 5, and 6 cardiac education classes.

The second question posed by this investigation examined potential differences in demographic and initial variables between the education groups. The analysis indicated that gender, age, diagnosis, number of risk factors, working status, level of education, program adherence, MET level attained on the initial GXT, initial education test score, and initial SF-36 MCS and PCS scores were not significantly different between education groups. A significant difference was found between the education groups for ejection fraction and entrance 12 minute walk distance, with Group 0-1 achieving a significantly lower ejection fraction and 12 minute walk distance than participants who attended more than one cardiac education class.

The third question examined by this investigation examined potential differences in post intervention physiological outcomes (exercise duration, 12 minute walk distance and MET level) between education groups. Results of the MANCOVA indicated that attendance in cardiac education classes had no significant relationship with physiological outcomes.

The last question examined by this investigation examined the impact of cardiac education classes on quality of life outcomes as measured by the SF-36. At baseline, participants were not significantly different in PCS or MCS quality of life scores. At the conclusion of their cardiac rehabilitation program, participants achieved significantly higher PCS and MCS quality of life scores when compared to their pre scores, however, there were no significant differences in PCS quality of life scores in relation to the number of cardiac education classes attended. When examining the impact of cardiac education on MCS scores, a significant difference was found between the groups indicating a dose effect with Groups 0-1 and 2 statistically lower than Groups 3, 4, 5, and 6 and Group 3 lower than Groups 4, 5, and 6 which were not different from each other.

In conclusion, the dose effect of cardiac education attendance found in post cardiac education test scores and MCS quality of life outcomes suggested that a comprehensive cardiac education program developed from AACVPR guidelines can significantly improve specific outcomes.

Implications of these results and recommendations for future research on the efficacy of cardiac education in cardiac rehabilitation programs are discussed.

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