Education is an important element of phase I CR, aiming to decrease the patients' anxiety, and meet the patients' perceived learning needs (Turton, 1998). It should also enable patients to retain the information they are given (Waitkoff and Imburgia, 1990). It is imperative to remember, when working with patients, that each patient is unique, bringing with him or her past experiences, perceptions, coping mechanisms, personalities, support systems, strengths and weaknesses (Robinson, 1999). Thus, appropriate, individualised education is required. The education component should adhere to adult education principles including (SIGN, 2002):

• relevance (tailored to patients' knowledge, beliefs and circumstances);

• feedback (informed regarding progress with learning or change);

• individualisation (tailored to personal needs);

• facilitation (provided with means to take action and/or reduce barriers);

• reinforcement (reward for progress).

In addition, it is recommended that written information is given (SIGN, 2002). This may be, for example, in-house booklets, BHF booklets, or the Heart Manual, which is a comprehensive home-based programme (Lewin, et al., 1992). A patient-held record card or treatment plan is also recommended (BACR, 1995; DoH, 2000).

The content of this part of phase I CR should include educational advice regarding:

• risk factors (modifiable and non-modifiable);

• anatomy and physiology of the heart;

• clinical management of CHD;

• cardio-protective diet;

• sensible alcohol use;

• the benefits of exercise;

• cardiac misconceptions;

• return to driving, employment and hobbies;

• psychological aspects of CHD and stress management;

sexual activity;

Giannuzzi, et al. (2003) examined secondary prevention through CR and suggest much less time is now available to teach the skills required to monitor exercise activity and to cover the other phase I components. With the decreasing length of hospital stay, there is a challenge for health professionals to deliver phase I in shorter periods of time. With short phase I, physiological deconditioning is minimal (Giannuzzi, et al., 2003).

Do Not Panic

Do Not Panic

This guide Don't Panic has tips and additional information on what you should do when you are experiencing an anxiety or panic attack. With so much going on in the world today with taking care of your family, working full time, dealing with office politics and other things, you could experience a serious meltdown. All of these things could at one point cause you to stress out and snap.

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