Abstract
Background: Coronary heart disease (CHD) and acute coronary syndrome (ACS) remain significant public health problems. The effect of ACS on mortality and morbidity is largely dependent on the time from symptom onset to the time of reperfusion, but patient delay in presenting for treatment is the main reason timely reperfusion is not received. Objectives: We tested the effect of an education and counseling intervention on knowledge, attitudes and beliefs about ACS symptoms and the appropriate response to symptoms, and identified patient characteristics associated with changes in knowledge, attitudes and beliefs over time. Methods: We conducted a two-group randomized controlled trial in 3522 people with CHD. The intervention group received a 40 min, one-on-one education and counseling session. The control group received usual care. Knowledge, attitudes and beliefs were measured at baseline, 3 and 12 months using the ACS Response Index and analyzed with repeated measures analysis of variance. Results: Knowledge, attitudes and beliefs scores increased significantly from baseline in the intervention group compared to the control group at 3 months, and these differences were sustained at 12 months (p = .0005 for all). Higher perceived control over cardiac illness was associated with more positive attitudes (p < .0005) and higher state anxiety was associated with lower levels of knowledge (p < .05), attitudes (p < .05) and beliefs (p < .0005). Conclusion: A relatively short education and counseling intervention increased knowledge, attitudes and beliefs about ACS and response to ACS symptoms in individuals with CHD. Higher perceived control over cardiac illness was associated with more positive attitudes and higher state anxiety was associated with lower levels of knowledge, attitudes and beliefs about responding to the health threat of possible ACS.
| Original language | English |
|---|---|
| Pages (from-to) | 1037-1046 |
| Number of pages | 10 |
| Journal | International Journal of Nursing Studies |
| Volume | 46 |
| Issue number | 8 |
| DOIs | |
| State | Published - Aug 2009 |
Bibliographical note
Funding Information:Funded by National Institutes of Health, National Institute of Nursing Research (R01 NR07952). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Nursing Research or the National Institutes of Health. Technical Assistance: The authors thank additional Project Directors Beverly Carlson, Rebecca Cross, Patricia Howard and Valerie Rose for managing the project, and Senior Hospital Scientist, Phillip Johnson, for database development and support. Conflict of interest : No authors have conflicts of interest to declare. Funding : US NIH National Institutes of Nursing Research RO1 NR007952. The funding source had no involvement in any aspect of the study design, its execution or reporting. Ethical approval : Approval for the study was obtained from the Institutional Review Boards, Human Research Ethics Committees, or equivalent of each of the investigators’ institutions and study sites at which patients were recruited. University of California San Francisco IRB approval #H11308-18383-09; University of Pennsylvania IRB approval #706682; Northern Sydney Area Health Service HREC 0009-164M; South Eastern Sydney Area Health Service HREC 00/82M; University of Technology Sydney HREC 00/73A.
Keywords
- Acute coronary syndrome
- Coronary heart disease
- Education and counseling
- Randomized controlled trial
- Time factors
ASJC Scopus subject areas
- Nursing (all)
