Family Business: Living with Heart Disease.

Prospect Media Inc and Northwood Entertainment, producers. New York, NY 10001, Prospect Media Inc, 1990, VHS, 47 min, :$150.

The purpose of this videotape is to give a patient's view of what living with heart disease is like. It is patient oriented, but health care professionals and students of health care fields could benefit as well. The purpose of the videotape is successfully carried out in a soberingly realistic fashion.

The format consists totally of patient comments. The patients are often talking directly into the camera, but there are a number of scenes that portray conflicting situations that the patient and his or her family members are experiencing. Because of the repeated scenarios, you may sometimes wonder what is real and what is staged. The actors, who range in age from 42 to 75 years, are people who actually have heart disease. The family members talk very honestly about how the patient has, or has not, dealt with the condition. The ways in which the family life has been disrupted or limited is honestly and repeatedly demonstrated.

The videotape moves from patient to patient and often repeats visits with a familiar patient to demonstrate a particular issue that has not been previously discussed. There is no narrative; perhaps a professional narrative, or someone hosting the segments, might have helped to point out particularly relevant themes. Graphics might also have helped to demonstrate some of the medical issues described by the patients.

The treatment of the subject matter is thorough and very realistic. The patients have been through serious health events, but overall, instead of motivating the viewer, this videotape leaves one with a more depressed feeling. Some patients give vivid descriptions of their experiences in the cardiac intensive care unit, including the horror and isolation of it. One patient, reflecting on his open heart surgery, speaks honestly. He says that if he had to go through the surgery again, he would choose not to, and instead just live with the risk of the disease. It is comments like this one that often taint what should be a motivating theme of this videotape. There are also patients featured who indicate that they have started smoking again, against their family's wishes and even though another heart attack could result.

There is effective discussion, particularly for men, about the issues of sexual problems that are secondary to some of the medications the patients must take. This discussion is handled realistically and honestly. The reactions of some of the patients' spouses and children contribute to a greater awareness of how heart disease affects the entire family.

The information in this videotape is current and valid, but, in light of the fact that one of the purposes of this videotape is to motivate the patient who has heart disease, I would be cautious in using it, as some of the patients in the videotape give depressing and angry views about what has happened to them. A few patients do describe the joy of being alive and how fortunate they were to survive their heart disease episodes, but these views are not prominent in this videotape.

The production quality is good. Because the actors are people who actually have heart disease, their stories lend important relevance to understanding this chronic disease. Included with the videotape is a brief, but effective, discussion guide that may be used by people with heart disease, as well as by health care professionals.

People with heart disease would gain some important insights from this videotape, but I do caution that it is somewhat depressing and not as motivating as it could be. It would be a superb tool for clinical educators and health care professionals, providing insight into the struggle the person with heart disease and his or her family deals with on a daily basis.

Barbara S Oremland, PT Lyndhurst, Ohio