Factors affecting the use of self-instructional material by patients with ischemic heart disease

This study addressed three questions concerning the feasibility of self-instruction by patients with ischemic heart disease in an acute-care teaching hospital. (1) Do patients complete a linear self-instructional booklet under conditions normally prevailing on a hospital ward? (2) Do patients perceive that activity in the ward environment and symptoms of illness affect use? (3) What aspects of activity and symptoms do patients report affect use? One hundred patients, 60 men and 40 women with an average age of 59 years, hospitalized with ischemic heart disease (acute myocardial infarction or unstable angina) were interviewed an average of six days after distribution of a self-instructional booklet as a component of a standard teaching program. Three subjects claimed not to have received the booklet; nine made no use of it; 73 made partial use of it; and 15 made complete use of it. Fifteen subjects claimed activity in the ward environment and 25 subjects claimed symptoms of illness affected use. Interruption, a noisy, busy atmosphere on the ward, and physical symptoms of ischemic heart disease were reported most frequently as factors affecting use. Results of the study suggest that a small percentage of patients will complete a self-instructional booklet. In addition to activity in the environment and symptoms of illness, factors not identified in this study also appear to influence the use of self-instructional material.