Promoting Patient Engagement During Hospitalization for Acute Myocardial Infarction

Background: Higher levels of patient engagement are associated with improved patient outcomes, but patient engagement is rarely studied in acute cardiology populations. Promotion of patient engagement during hospitalization after acute myocardial infarction (AMI) may play a role in improving cardiac rehabilitation (CR) participation.

Objective: The purpose of this study was to examine the feasibility of utilizing a CR-specific question prompt sheet (QPS) to promote patient engagement during hospitalization for inpatients diagnosed with AMI.

Methods: A descriptive correlation study was conducted over eight weeks on two cardiovascular units at an academic medical center. A convenience sample of 32 (N) inpatient adults with AMI and 4 (N) physicians participated. Patients received a CR-specific QPS with encouragement to ask questions, supplemented by education for physicians and nurses. Patient engagement was measured by observed question-asking behavior and Patient Involvement Questionnaire (PIQ).

Results: Twenty of the 32 patients asked questions during rounds with a median of one question (IQR 2) for the length of stay. Although question-asking behavior and PIQ scores were not found to be statistically different in those intending to attend CR compared to those who were not, patients who expressed positive intention, tended to have higher PIQ scores. The majority of patients who received endorsement from physician or clinical nurse endorsed positive intention to attend CR, with relationship between CR nurse endorsement and intention to attend approaching significance (X2 [1, N=13] =5.318), Exact 2-sided, p= .077). Patients reported the QPS helped them ask questions, but some physicians perceived it increased duration of rounds.

Conclusion: Although a CR-specific QPS may be helpful and trends suggest potential to increase patient engagement, further research is needed to determine the feasibility and effectiveness of the QPS in promoting patient engagement for patients hospitalized with AMI.