Relation of the Readiness for Hospital Discharge after Myocardial Infarction Scale to socio-demographic and clinical factors. An observational study

Introduction: The aim of the study was to analyse the relationship between the Readiness for Hospital Discharge after Myocardial Infarction Scale (RHD MIS) scores and socio-demographic and clinical factors in patients after acute myocardial infarction (AMI) treated with percutaneous coronary angioplasty. Material and methods: The study was conducted as a single-centre, prospective, cohort, 6-month observa-tion, including 213 patients: 59 women and 154 men aged 30–91 years (average age of 62,91 ± 11.26 years). Results: Patients’ economic status was found to have a significant impact on the readiness for discharge measured by RHD-MIS general score. Among all three investigated RHD-MIS subscales, objective assessment of knowledge was influenced by gender (p = 0.012) and place of residence (p = 0.025). There was a linear trend for increase of knowledge along with increase in education level (p = 0.030). The only factor influencing patients’ expectations was their economic status (p value for heterogeneity: 0.014). A linear correlation between growing of patients’ expectations and worsening of their economic status (p = 0.008) was observed. Conclusion: Readiness to discharge should be routinely assessed in all patients hospitalized with myo-cardial infarction. The result of this assessment should be used to identify patients requiring additional education. Further research is prompted to determine the cut-off values of RHD-MIS results qualifying patients for additional educational interventions

The impact of readiness to discharge from hospital on adherence to treatment in patients after myocardial infarction

Background: The healthcare professionals involved in in-hospital treatment of myocardial infarction (MI) are also responsible to patients for their education before leaving the hospital.   This education aims to modify patient behaviour in order to reduce relevant risk factors and improve self-control and adherence to medications. The aim of the study was to analyse the relationship between readiness for discharge from hospital and adherence to treatment at follow-up in MI patients. Methods: An observational, single-center, MI cohort study with  6-month follow-up was conducted between May 2015 and July 2016.  The Readiness for Hospital Discharge after Myocardial Infarction Scale (RHD-MIS) and the Adherence in Chronic Diseases Scale (ACDS) were applied. Results: Two hundred and thirteen patients aged 30–91 years (62.91 ± 11.26) were enrolled in the study. The RHD-MIS general score ranged from 29 to 69 points (51.16 ± 9.87).   A high level of readiness was found in 66 patients (31%), intermediate in 92 (43.2%), and low in 55 (25.8%) of patients. Adherence level assessed with the ACDS 6-months after discharge from hospital ranged from 7 to 28 points (23.34 ± 4.06). An increase in objective assessment of patient knowledge according to RHD-MIS subscale resulted in significantly higher level of adherence at the follow-up visit (p = 0.0154); R Spearman = 0.16671, p = 0.015; p for trend = 0.005. During the 6-month follow-up 3 (1.41%) patients died and 17 (7.98%) were hospitalized for a subsequent acute coronary syndrome. Conclusions: This study provided preliminary evidence of a long-term association between the results of assessment of readiness for discharge from hospital and adherence to treatment in patients after MI

Knowledge and learning preferences of patients with myocardial infarction

Introduction. The objective of the research was to study the knowledge about ischaemic heart disease and learning preferences of hospitalised patients as a result of myocardial infarction. Methods. The tested group comprised of 248 patients, aged 63 ± 11.25, who were hospitalised as a result of myocardial infarction A questionnaire with 20 single-choice questions was used in the research. The questionnaire tested the knowledge of the patients as far as ischaemic heart disease, myocardial infarction symptoms, and preventive healthcare are concerned. The patients were divided into groups depending on what knowledge sources on ischaemic heart disease they preferred — brochures, magazines, radio and TV, individual talks, group talks, films, the Internet. Results. The proportion of correct answers was 58.49 ± 19.89%; in the area of the disease knowledge 62.74 ± 31.52%; in the area of the preventive healthcare 57.14 ± 23.38%; and in the area of the disease symptoms 56.94 ± 25.84%. The source of health knowledge selected the most was educational brochures (80.2%), while radio and TV was selected the least (17.6%). The knowledge varied depending on patients’ preferences: so those who selected films — the knowledge of the disease symptoms was higher compared to the others (64.44 ± 26.93% vs. 55.27 ± 25.35%; p = 0.02; those who selected individual talks — the knowledge of the disease symptoms was lower compared to the others (55.33 ± 24.80 vs. 61.68 ± 26.51; p = 0.007); those who selected group talks — the knowledge of the disease symptoms was higher compared to the others (62.30 ± 28.07 vs. 55.16 ± 24.96; p = 0.02). As far the other two areas of knowledge are concerned, there were no significant differences in any group. Conclusions. Educational brochures are the most preferred source of knowledge about ischaemic heart disease by hospitalised patients as a result of myocardial infarction. The knowledge of ischaemic heart disease in patients with myocardial infarction is inadequate and it is not connected with patients’ preferences from the point of view of learning methods.