Introduction

Cardiac rehabilitation in the form of patient education has become an integral part of treatment during hospitalization for patients recovering from a heart attack. Although it is well established that cardiac education programs lead to significant gain in knowledge about rehabilitation (1-3), the impact of information gained on subsequent recovery from myocardial infarction (MI) remains unclear. Some studies have demonstrated that higher levels of information lead to minimal or even negative effects on the recovery process (4-6), whereas others have shown that the amount of information gained during cardiac education is positively related to compliance with diet and drug regimens, reduced readmission to the hospital (7), and increased return to work and decreased smoking (8). The findings of one study suggest that the crucial factor is not merely the level of information, but rather the combination of information and other rehabilitation factors. Cromwell et al. (6) randomly assigned patients admitted to the Coronary Care Unit into groups in which the amount of information, the level of outside stimulation, and the extent to which patients were allowed to participate in their own treatment were all experimentally controlled. They found that patients who experienced high levels of information and were allowed to engage in activities to help themselves but who also had low levels of stimulation and diversion spent the fewest days in the CCU and had the shortest total hospital stay.