The specific aim of the proposed experimental, time-series design study is to examine the influence of a post-hospitalization nursing intervention on medical regimen adherence and return to desired life style of myocardial infarction (M.I.) patients. One hundred subjects will be randomly assigned to a treatment or control group. At one month post-hospitalization, the experimental group will be given the Nursing Intervention which consists of three steps: Step 1: Patient Assessment. Data will be obtained by patient self-assessment of adherence, attitude, life adjustment problems, and coping methods. In addition, adherence will be verified by the spouse. Step 2: Problem Identification. The data from Step 1 will be evaluated and discussed jointly by the patient, spouse, and nurse, to identify specific patient needs and alternative actions for dealing with them. Step 3: Individual Follow-up. An individualized health plan will be developed by the patient, with input from the spouse and the nurse, for achieving specific goals related to the problems of attitudes, regimen adherence, coping mechanisms, and societal adjustment. The control group receives no intervention after discharge from the hospital. All subjects in the study will complete the five data collection scales at three time points: prior to discharge from the hospital, at one month post-hospitalization, and at two months post-hospitalization. Data will be analyzed using the analysis of variance techniques. If the post-hospitalization nursing intervention is found to increase regimen adherence and return to desired societal functioning, there would be implications for restructuring rehabilitation programs so as to place emphasis on interventions post-hospitalization, rather than during hospitalization.
