Alienation and social learning among patients with heart disease
Date
1971
Authors
Gauthier, Marie Rose
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Abstract
When personal alienation is defined as perceived powerlessness to control one's fate in critical life situations, it is presumed to act as a deterrent to relevant social learning and hence to active control of events. The present study attempts to relate the differential feelings of powerlessness of patients with acute coronary heart disease to their learning about their illness and the influence of this knowledge on their compliance to a medical regimen and on their post-illness adjustment.
Thirty-eight male patients with acute coronary heart disease participated in the study. Data were collected by means of personal interviews using a structured schedule of questions. Nineteen subjects (the comparison group) received varying but essentially incidental health instruction. They were interviewed two to four weeks following discharge from hospital. The remaining nineteen treatment subjects were exposed while in hospital to an experimental health education program and subsequently interviewed at the time of discharge and gain from one to three weeks later.
It was hypothesized that subjects lower in alienation would have greater knowledge about their illness and its management, would show greater compliance to the medical regimen and hence would experience less post-coronary disability.
Results were first analyzed using the Kendall Rank Correlation Coefficient (r) which indicated a stronger negative relationship between alienation and knowledge in the comparison group; and likewise between compliance and post-coronary disability in treatment group. A stronger positive relationship between knowledge and compliance obtained for the comparison group. While lending some support to the proposed hypothesis, none of the correlations was statistically significant. Thus it was further hypothesized that the experimental program rather than alienation was more influential in effecting positive increases in knowledge and compliance, while reducing post-coronary disability in treatment subjects. Scores for both groups dichotomized at the median for the combined groups, and between-group differences were analyzed using Chi Square Test. Differences between the two groups on the three variables were all statistically significant (<.05) in favour of the treatment group. Methodological limitations such as a unidimensional alienation scale, time differences in collecting data from the two groups, and the active participation of the researcher in the experimental project are thought to account, at least in part, for the marked differences observed between comparison and treatment groups.
Results of the study do not lend strong support for the proposed influence of alienation on social learning in this group of patients, but there is stronger evidence that when coronary health instruction is comprehensive and prescriptions clearly defined, patients tend to learn more about their illness, comply more readily to recommend control measures and experiences less post-coronary role disability.