The purpose of this study was to operationalize the coronary care patient's concept of hope. Analysis of 25 subjects' responses to an open interview format suggested that the sample's definition of hope revolved around five categories. These categories were: 1) theistic beliefs: 2) knowledge that they would not die, require surgery, or experience pain; 3) a wish not to die; 4) a wish to get better; and, 5) confidence that they would get better. Furthermore, significant differences in: 1) the sample's definition of hope: 2) the feelings associated with admission to the coronary care unit: and, 3) the factors that positively influenced the sample's level of hope were directly related to the subject's age.

A descriptive design was utilized to identify the relationship between perceived cardiac rehabilitation at the time of discharge and perceived self-care three months later. Perceived cardiac rehabilitation was indicated by perceived quality of the cardiac rehabilitation program, perceived understanding of self-care, and satisfaction with hospital care. Perceived self-care was indicated by self-reported self-care related exercise, stress management, and medication. Fifty-three patients from a community hospital voluntarily participated in the study by responding to four questionnaires. A low positive relationship was found between (a) perceived quality of the cardiac rehabilitation program and self-reported stress management, (b) perceived understanding of self-care and self-reported exercise and stress management, and (c) satisfaction with hospital care and self-reported exercise and medication administration. These findings of post-hospital care are useful in the evaluation of the effectiveness of one nurse-coordinated cardiac rehabilitation program.

No description available.

Coronary Heart Disease (CHD) accounts for almost 20% of all deaths in the United States and is a leading cause of premature death and disability. The cost for this disease includes not only lost work years, but billions of health care dollars. Women account for almost half of the deaths from CHD and rates for the death of young women have risen 30% from 1988 to 1998. For the two-thirds of women who survive the initial coronary event, the risk of future events and disability increases. Cardiac rehabilitation (CR) is a multi-disciplinary program designed to reduce this risk. Unfortunately, only 25% of eligible women attend the program. Few studies have analyzed the factors that influence women's CR enrollment choices making a careful examination of these factors particularly relevant. The purpose of this study was to qualitatively explore the factors associated with a woman's decision to enroll, or not enroll, in CR from the perspectives of the patient and her support person. Twenty-five women (15 enrolled in CR, 10 not enrolled in CR) and 24 matched support persons (one person's supporters refused to participate) were interviewed using a semi-structured format from September, 1999 to January, 2001. Questions addressed the beliefs, affect, social referents, past experiences/habits, and facilitating/constraining conditions related to CR enrollment choices. Support persons were asked to respond to these questions from their perception of their loved one's attitudes, beliefs and health care seeking behaviors. Information from the interviews was transcribed verbatim, entered into NUD*IST, and coded using the components of the Expanded Theory of Reasoned Action (Triandis, 1977) as a framework. Descriptive analyses was done on basic demographic information, including perceptions of health and depression. There were specific factors identified in each of the primary categories of affect, beliefs, facilitating/constraining factors, and social referents and information. The key findings indicated that a lack of information on CR, feelings related to the perceived necessity of CR, transportation, finances, and accessibility were primary factors in enrollment behavior. Overall agreement between the cardiac female and her support person existed in most categories, except affect, where a minimum number of emotions was stated by the supporter. Cardiologists are a preferred source for CR information and they and primary care physicians need to increase the amount of positive support they provide to post-coronary event women. Emphasis on the necessity of attending CR as well as solutions for transportation and finances may increase enrollment. More research should be completed on the context of depression related to CR, importance of factors identified as having an impact on CR decision making, and the role of support persons in the enrollment choices of women. / Graduation date: 2002

Access to abstract permanently restricted to Ball State community only / Access to thesis permanently restricted to Ball State community only / School of Physical Education, Sport, and Exercise Science

published_or_final_version / Nursing Studies / Master / Master of Nursing in Advanced Practice

No description available.

No description available.

Purpose: The primary purpose of this study was to determine if a pedometer-driven physical activity (PA) intervention with individualized stepcount goals would be more efficacious in yielding greater amounts of PA than the usual time-based PA recommendations given to maintenance CR patients. Additionally, the secondary purpose of this study was to assess differences in stepcount activity on days attending maintenance CR and on non-rehab days. Methods: Subjects entering maintenance CR for the first referral were recruited for study participation and stratified into pedometer feedback (PF) and usual care (UC) groups. All subjects wore a New Lifestyles NL-1000 pedometer. PF subjects wore the pedometer for the duration of the 8-week study. For comparison, UC subjects wore the pedometer at baseline, week 4, and week 8.Both groups were encouraged to accumulate a minimum of 40 - 50 min/d at moderate intensity when attending maintenance CR. UC subjects were encouraged to follow-up with at least 30 min/d PA outside maintenance CR, while PF subjects were given daily stepcount goals. Stepcount goals were calculated as 10% of baseline stepcounts and added weekly to increase daily goal. All subjects completed a 6- minute walk test at baseline and week 8, and behavioral change questionnaires were completed at baseline, week 4, and week 8. Results: A total of 18 subjects (PF, n = 9, 53.7±8.0; UC, n = 9, 60.2±9.6 yrs) completed the 8-week study. There were no differences between groups at baseline. PF group increased daily stepcounts by week 4 (19%, 1,080±649 steps/d) and 8 (44%, 2,468±846 steps/d) in addition to days attending rehab by week 4 (14%, 1064±45 steps/d) and 8 (36%, 2,711±423 steps/d) and non-rehab days by week 8 (42%, 1,747±759 steps/d). PF subjects accumulated greater daily stepcounts compared to UC subjects at weeks 4 (26%, 1,405±393 steps/d) and 8 (48%, 2,612±284 steps/d). UC subjects accumulated greater stepcounts on rehab compared to non-rehab days, but no changes were found from baseline for daily stepcounts, rehab, or non-rehab days. There was a time effect for responses to social support from friends for all subjects (baseline to week 4) and a time by group effect for decision balance pro-questions by week 4 where PF significantly increased, UC significantly decreased, and both groups where significantly different. Conclusions: The results of this study suggest that a pedometer-driven PA intervention yields significantly greater stepcounts compared to time-based PA recommendations among maintenance CR patients. / School of Physical Education, Sport, and Exercise Science

Clinically, the modified Bruce protocol is widely used to predict functional capacity in cardiac patients. However, it has been suggested that cardiac patients have lower oxygen uptakes for standard workloads. In order to study this, we measured oxygen uptake (V02) and venous bloodV02 derived from lactic acid concentration during a modified Bruce treadmill protocol in 12 pest myocardial infarction (MI) and 12 normal males. During three stages of the protocol mean oxygen uptake was significantly lower (1.42 - 6.2 ml/kg.min; p < .001) for the pest MI than the normal males.However, venous blood lactic acid concentrations were not different at these stages. The MI patients' measured V02 for three stages of the protocol ranged from 1.8 - 7.3 ml/kg.min lower than the Bruce predictions for cardiacs. In addition, measured V02 (max) for cardiac patients were from 3.68 to 11.15 ml/kg.min lower than the predicted the normal subjects. These data suggest myocardial damage may slow oxygen kinetics and results in lower actual V02during treadmill testing. However, blood lactic acid concentrations failed to demonstrate an anaerobic compensation for the lower V02 in pest MI patients.