Evaluation of quality of life among patients with ischemic heart disease who practiced self-care activities at home after elective percutaneous coronary intervention

Effects of empowerment education on patients after percutaneous coronary intervention: A meta-analysis and systematic review

BACKGROUND

Empowerment education is a new nursing education model with great significance in the process of chronic disease rehabilitation, and a number of studies have found that it has good benefits for patients after percutaneous coronary intervention (PCI). But there is no meta-analysis on how empowerment education influence the life of patients after PCI.

AIMS

Our study intends to evaluate the impact of empowerment education on the quality of life, cognitive level, anxiety and depression level of patients after PCI.

DESIGN

Systematic review and meta-analysis, following PRISMA guidelines.

METHODS

RevMan5.4 software and R software were used for statistical analysis. Mean difference or standard mean difference was used as effect analysis statistic for continuous variables with 95% confidence intervals.

RESULTS

Six studies met the inclusion criteria, including 641 patients. The Exercise of Self-Care Agency Scale score of the experimental group was higher than that of the control group, with statistically significant difference. Empowerment education could increase the knowledge of coronary heart disease in patients after PCI, but the difference was not statistically significant.

CONCLUSION

Significant effects of empowerment have been found in improving patients' quality of life and self-care ability. Empowerment education could be a safe exercise option in PCI rehabilitation. However, the effect of empowerment on cognitive level for coronary heart disease and the depression needs to carry out more large-sample, multi-center clinical trials.

PATIENT OR PUBLIC CONTRIBUTION

A data-analysis researcher and 3 clinicians are responsible for the writing, and no patients participated in the writing of this paper.

Nurse-led psychological intervention reduces anxiety symptoms and improves quality of life following percutaneous coronary intervention for stable coronary artery disease

OBJECTIVE

To study the effect of nurse-led counselling on the anxiety symptoms and the quality of life following percutaneous coronary intervention for stable coronary artery disease.

DESIGN

Randomised control trial.

SETTING

Rural and remote China.

PARTICIPANTS

Rural and remote patients were consecutively recruited from a medical centre located in China between January and December 2014.

INTERVENTIONS

The control group received standard pre-procedure information from a ward nurse on the processes of the hospitalisation and percutaneous coronary intervention, and post-procedural care. The intervention group received a structured 30-minute counselling session the day before and 24 hours after the percutaneous coronary intervention, by nurse consultants with qualifications in psychological therapies and counselling. The health outcomes were assessed by a SF-12 scale and the Seattle Angina Questionnaire at 6 and 12 months after percutaneous coronary intervention. The anxiety and depression symptoms were evaluated by a Zung anxiety and depression questionnaire.

MAIN OUTCOME MEASURES

Cardiac outcomes, quality of life and mental health status.

RESULTS

Eighty patients were randomly divided into control (n = 40) and intervention groups (n = 40). There was a significant increase in the scores of the three domains of Seattle Angina Questionnaire 12 months after percutaneous coronary intervention in the intervention group (P < .01). The mental health and physical health scores also increased (P < .01). In the control group, the mean scores of Zung self-rating anxiety scale 12 months following percutaneous coronary intervention were higher than the baseline scores, and higher than in the intervention group (P < .01).

CONCLUSIONS

Counselling by a clinician qualified in psychological therapies and counselling significantly reduces anxiety symptoms and improves quality of life.

Influence of Health Literacy on HRQoL in Patients After PCI

Among increased concerns about the adverse health outcomes of inadequate health literacy, it still remains unclear how health literacy influences health-related quality of life (HRQoL) of patients who have undergone percutaneous coronary intervention (PCI). Therefore, the aim of the study was to examine the impact of health literacy on HRQoL in PCI patients at 6 months after discharge. This study used a self-reported questionnaire to assess health literacy, medication knowledge, and HRQoL in 238 patients. In hierarchical linear regression, health literacy was the strongest predictor of HRQoL after adjusting confounding factors (β = .23, p = .003). In addition, this study showed that medication knowledge acted as a partial mediator between health literacy and HRQoL. In conclusion, adequate health literacy is a contributing factor to better HRQoL in patients after PCI, and health literacy can lead to improved HRQoL in PCI patients through the acquisition of sufficient medication knowledge.