ERIC Number: ED480837
Record Type: RIE
Publication Date: 2001-Jun
Reference Count: N/A
Expanding the Limits of Evidence-Based Medicine: A Discourse Analysis of Cardiac Rehabilitation Clinical Practice Guidelines.
Heart attacks are the leading cause of death in the United States, and cardiac rehabilitation, a form of post-MI (myocardial infarction) education, accounts for at most 20% of improved lifestyle behavior that can effectively manage symptoms, delay or prevent subsequent attacks, and lower mortality and morbidity rates. In an attempt to improve post-MI education, the U.S. Agency for Health Care Policy and Research used evidence from a comprehensive analysis of published scientific research to created guidelines that suggested changes to existing practices. Dimensional analysis of evidence contained in the guidelines (such as gender, age, and insurance status of participants) and evidence that was not contained in the guidelines (gathered from qualitative and quantitative studies about the social, emotional, and economic aspects of heart disease) was used to identify the promises and pitfalls of the guidelines. Findings suggest that the cardiac rehabilitation guidelines are based upon a rational behavior change educational orientation that does not meet many participants' needs. It is recommended that adult educators include a focus on mind-body integration, as behavior change is often conditional upon prior meaning making. In addition, transformative learning and critical popular education are recommended to address issues of social justice and cardiotoxic social policy that are not addressed in the cardiac rehabilitation guidelines. (Contains 26 references.) (MO)
Descriptors: Adult Education, Behavior Change, Behavior Development, Cardiovascular System, Context Effect, Criticism, Data Analysis, Heart Disorders, Life Style, Patient Education, Popular Education, Preventive Medicine, Program Design, Program Effectiveness, Qualitative Research, Rehabilitation Counseling, Rehabilitation Programs, Research Methodology, Teaching Methods, Transformative Learning
For full text: http://www.edst.educ.ubc.ca/aerc/2001/2001wise.htm.
Publication Type: Opinion Papers
Education Level: N/A
Authoring Institution: N/A
Note: Paper presented at the Annual Meeting of the Adult Education Research Conference (42nd, Lansing, MI, June 1-3, 2001).