| Description |
Four spheres of effectiveness of patient teaching program were evaluated using a hypothetical model derived from compliance literature. These areas were: (1) patient participation in teaching program, (2) comprehension of teaching directives, (3) perceived teaching efficacy, and (4) compliance. Patient participation in the teaching program and the time period since teaching occurred were conceived a key intervening factors influencing patient's comprehension of teaching directives, perceived teaching efficacy, and compliance. Eight factors selected from compliance studies: (1) age, (2) sex, (3) education, (4) subjective severity of illness, (5) objective severity of illness, (6) personal relationship with physician, (7) personal relationship with teaching staff, and (8) family cooperation served as basic determinants of the four spheres of program effectiveness. Data were obtained via a mail survey on sample of 73 post myocardial infarction patients who had attended the Cardiac Rehabilitation Program classes at LDS Hospital in Salt Lake City during the one year period of August, 1977 to July, 1978. A statistical technique, path analysis, evaluated the relative importance of relationships among variables. Five major findings resulted from the analysis. First, the most important factor associated with participation in the teaching program was family cooperation. Second, the comprehension of teaching directives was not successfully explained by given variables due to small data variation. Most chronically ill patients already had a certain amount of knowledge regardless of participation in the teaching program. Third, the perceived teaching efficacy was best explained of the four spheres of teaching effectiveness delimited in the model. Major factors contributing to perceived teaching efficacy were personal relationship with teaching staff, participation in the teaching program, and patient age. Fourth, compliance to dietary directives revealed complicated and unexpected relationships. Among three major determinants of dietary compliance, a positive personal relationship with the physician negatively affected dietary compliance. Second, increased dietary compliance was associated with longer time periods since teaching directive were given. The third influential factor, objective severity of illness, showed a negative effect on dietary compliance. Finally, the major positive factor related to perceived teaching efficacy of the Cardiac Rehabilitation Program were participation in the teaching program, family cooperation, and personal relationship with teaching staff, while obstacles to program effectiveness appeared to be lack of physician cooperation with the program, chronic and serious illness in patients and excessive age of participants. |
