Correlates of health behaviors in patients with coronary artery disease

The Effect of Providing Education to Patients Undergoing Coronary Angiography on Vital Signs

PURPOSE

This study was conducted to determine the effect of providing preprocedural education to patients undergoing coronary angiography on their vital signs.

DESIGN

The study was a randomized controlled experimental study with a pretest/post-test control group design.

METHODS

The study was conducted in the Cardiology Service of a hospital in Eskişehir between November 2021 and April 2022. Power analysis identified that it was appropriate to include 79 individuals in the experimental group, 79 individuals in the control group, and a total of 158 individuals. The experimental group was trained using the "Structured Education Manual" prepared by the researchers.

FINDINGS

The education had an influence on the stabilization of vital signs after the procedure compared to preprocedure. When the comparison of vital signs before and after the education was analyzed, systolic blood pressure and diastolic blood pressure differed significantly between 11 measurements in both groups (P < .05). The systolic and diastolic blood pressure of the experimental group measured before the procedure was higher than their other measurements after the procedure. Heart rate, respiratory rate, and saturation value in both groups displayed a statistically significant difference between 11 measurements (P < .05). In the experimental group, heart rate and respiratory rate before the procedure were higher than the postprocedure measurements. The saturation value of the experimental group at 150 minutes after the procedure was higher than the other measurements.

CONCLUSIONS

Education given to patients before undergoing a coronary angiography procedure had a positive effect on the patients' vital signs. It is recommended that patients undergoing a coronary angiography procedure be provided with audio-visual training by nurses before the procedure.

Psychometric Testing of the Korean Version of the Self-Care of Coronary Heart Disease Inventory Version 3

PURPOSE

This methodological study evaluated the psychometric properties of the Self-Care of Coronary Heart Disease Inventory version 3 (SC-CHDI v3) in a Korean context.

METHODS

The SC-CHDI v3 was translated into Korean following a rigorous translation process. Participants were 452 patients who had experienced coronary heart disease (CHD), all recruited from a tertiary hospital in Korea. Exploratory and confirmatory factor analyses were performed to test construct validity. Concurrent validity was examined by correlating scores from the Korean version of the SC-CHDI v3 with those from the Cardiac Self-Efficacy Scale. Internal consistency was analyzed using Cronbach's alpha and McDonald's omega.

RESULTS

The Korean version of the SC-CHDI v3 consists of 21 items, excluding two from the original instrument. The self-care maintenance subscale identified a two-factor structure: "treatment adherence" and "health-promoting behaviors." The goodness-of-fit indices were satisfied: χ2 = 18.19, p = .110, comparative fit index (CFI) = .97, Tucker-Lewis Index (TLI) = .95, and standardized root mean square residual (SRMR) = .04. The self-care monitoring subscale consisted of a one-dimensional structure ("monitoring behaviors") and the goodness-of-fit indices were satisfied: χ2 = 19.19, p = .059, CFI = .99, TLI = .99, and SRMR = .04. The self-care management subscales had a two-factor structure of "consulting behaviors" and "problem-solving behaviors." The goodness-of-fit indices were satisfied: χ2 = 16.44, p = .037, CFI = .99, TLI = .98, and SRMR = .03. Scores from the Cardiac Self-Efficacy Scale showed a positive correlation with the Korean version of SC-CHDI v3 subscales. Reliability estimates were ≥ .80 for all subscales except for the self-care maintenance subscale.

CONCLUSIONS

The Korean version of the SC-CHDI v3 consists of 21 items in 3 subscales and is a valid and reliable instrument. Therefore, healthcare providers can effectively utilize it to assess the self-care levels of patients with CHD.

A Comprehensive Review: Epidemiological strategies, Catheterization and Biomarkers used as a Bioweapon in Diagnosis and Management of Cardio Vascular Diseases

Coronary artery disease (CAD) is a serious health problem that causes a considerable number of mortality in a number of affluent nations throughout the world. The estimated death encountered in many developed countries includes including Pakistan, reached 111,367 and accounted for 9.87% of all deaths, despite the mortality rate being around 7.2 million deaths per year, or 12% of all estimated deaths accounted annually around the globe, with improved health systems. Atherosclerosis progressing causes the coronary arteries to become partially or completely blocked, which results in CAD. Additionally, smoking, diabetes mellitus, homocystinuria, hypertension, obesity, hyperlipidemia, and psychological stress are risk factors for CAD. The symptoms of CAD include angina which is described as a burning, pain or discomfort in the chest, nausea, weakness, shortness of breath, lightheadedness, and pain or discomfort in the arms or shoulders. Atherosclerosis and thrombosis are the two pathophysiological pathways most frequently involved in acute coronary syndrome (ACS). Asymptomatic plaque disruption, plaque bleeding, symptomatic coronary blockage, and myocardial infarction are the prognoses for CAD. In this review, we will focus on medicated therapy which is being employed for the relief of angina linked with CAD including antiplatelet medicines, nitrates, calcium antagonists, blockers, catheterization, and the frequency of recanalized infarct-related arteries in patients with acute anterior wall myocardial infarction (AWMI). Furthermore, we have also enlightened the importance of biomarkers that are helpful in the diagnosis and management of CAD.

Association of Cardiovascular Disease Risk and Health-Related Behaviors in Stroke Patients

Brain stroke continues to be a leading cause of mortality and disability in both developed and developing countries, with higher healthcare costs due to the long-term care and rehabilitation that it incurs. The purpose of the current study was to assess the association between brain stroke patients' health-related behaviors and their risk for cardiovascular disease.

METHODS

A cross-sectional study was carried out from March to August 2022 in the Vlora district regional hospital in Albania. The study included 150 out of 170 participants who met the necessary criteria, achieving an 88% response rate. Measurement tools included the Framingham Cardiovascular Risk Scale (FRS) and the Lifestyle Health Promotion Profile II (HPLP II).

RESULTS

The patients' average age was 65.9 ± 9.04 years. Over 65% of the stroke patients suffer from diabetes, and 47% from hypertension. About 31% of them have a high risk of hyperlipidemia (mean TC = 179 ± 28.5). About 32% of the brain stroke patients manifested unhealthy behaviors, while 84% of them had a high risk of cardiovascular disease (FRS = 19.5 ± 0.53). Cardiovascular disease (CVD) risk was statistically associated with stress management behaviors (p = 0.008; OR = 0.20; CI = 95%). This risk was highest in the over-70 age group as well as in men.

CONCLUSION

Brain stroke patients had a high probability of developing CVD. For better health among stroke patients, new evidence-based behavior change approaches must be introduced into preventative and management programs.

Illness Perception Predicting Cardiovascular Health Behaviors among Patients with Ischemic Heart Disease in Nepal: A Descriptive Cross-sectional Study

INTRODUCTION

Cardiovascular health behaviors refer to the activities done by individuals to prevent recurrence, minimize risk factors, improve survival, reduce recurrent events, control cardiovascular disease, and help prevent further complications. Illness perception may determine these behaviors. This study is aimed to identify level of illness perception, cardiovascular health behaviors and illness perception predicting cardiovascular health behaviors among patients with ischemic heart disease.

METHODS

The study was a descriptive cross-sectional study. Altogether 114 samples were selected using convenience sampling technique. Data was collected by using pretested semi-structured questionnaire. The data were analyzed using descriptive statistics.

RESULTS

Illness perception was at moderate level (M= 148.05, SD= 12.86) which represented a moderate threatening perception. The score of cardiovascular health behaviors was at a high level (M=92.14, SD=10.72).

CONCLUSIONS

The findings showed that illness perception can be a predictor of cardiovascular health behaviors.

Predictors of cardiac self-efficacy among patients diagnosed with coronary artery disease in tertiary hospitals in Nepal

Background: Cardiac self-efficacy determines how people feel, think, motivate themselves and behave with regards to improving their cardiac health subsequently preventing complications of coronary artery disease (CAD). Given almost one-third of global death is contributed by CAD with 10% of disability adjusted life years lost in low- and middle-income countries (including Nepal), it is important to identify factors that can promote cardiac self-efficacy. There are no studies in Nepal focusing on predictors of self-efficacy. Therefore, we aim to determine the predictors of cardiac self-efficacy of CAD patients in Nepal. Design and Methods: This is a cross-sectional study where we recruited 170 patients (≥30 years) diagnosed with CAD from two tertiary level hospitals. Multiple linear regression model was used to identify the predictors of cardiac self-efficacy. Results: The mean age of the participants was 60.45±10.39 years (range, 31-83). Most of the participants were diagnosed as myocardial infarction (91.2%), rest with unstable angina (6.5%) and stable angina (2.4%). The multivariate analysis shows age (p<0.001), health behaviors (p<0.001) and knowledge of the disease (p<0.001) were statistically significant predictors to cardiac self-efficacy. Every 1-year increase in age was associated with 0.23 units increase in cardiac self-efficacy score. Similarly, every unit increase in health behavior score and knowledge of disease score was associated with 0.432 units and 0.475 units increase in cardiac self-efficacy score respectively. Conclusion: Age and health behaviors were the strongest predictors of cardiac self-efficacy followed by knowledge of the disease. We conclude that those with poor health behavior are at a greater risk of poorer cardiac self-efficacy compared to those with relatively good level of self-efficacy. Public health interventions such as awareness raising about cardiac disease and health behavior modification along with early screening, diagnosis and appropriate care are essential to improving self-efficacy and cardiac care outcomes.

Evaluating Perceptions of Self-efficacy and Quality of Life in Patients Having Coronary Artery Bypass Grafting and Their Family Caregivers

BACKGROUND

Self-efficacy is a critical factor for quality of life in patients who undergo coronary artery bypass grafting, as well as for their family caregivers. However, there is lack of knowledge about whether patients' self-efficacy and caregivers' perceptions of patient self-efficacy are associated with quality of life in patient and caregiver dyads.

OBJECTIVES

The aims of this study were to compare self-efficacy and quality of life between patients and family caregivers and to examine whether patients' and caregivers' perceptions of patient self-efficacy were associated with their own and their partner's quality of life in patient and caregiver dyads who were waiting for patients' coronary artery bypass grafting.

METHODS

In this cross-sectional study, 84 dyads (85% male patients and 87% female caregivers) completed the Cardiac Self-efficacy Scale, which consists of self-efficacy for controlling symptoms and self-efficacy for maintaining function subscales, and the Short-Form 12 Health Survey for quality of life. Data were analyzed using the Actor-Partner Interdependence Model.

RESULTS

Caregivers rated patient self-efficacy for maintaining function higher than did patients themselves and caregivers' perceptions were positively correlated with patients' physical health. Patients' self-efficacy for maintaining function exhibited an actor effect on their own mental health. There were no other actor or partner effects of self-efficacy on quality of life.

CONCLUSIONS

Differences between patients' and caregivers' perceptions of patient self-efficacy for maintaining function should be addressed before surgery to reduce discordance. Patients' self-efficacy for maintaining function was associated with their own quality of life. There was no partner (relationship) effect of self-efficacy on quality of life. More research is needed in this area.

Chinese translation and psychometric testing of the cardiac self-efficacy scale in patients with coronary heart disease in mainland China

Background

A person’s self-efficacy plays a critical role during the chronic management process of a health condition. Assessment of self-efficacy for patients with heart diseases is essential for healthcare professionals to provide tailored interventions to help patient to manage the disease.

Objective

To translate and test the psychometric properties of the Chinese version of Cardiac Self-efficacy Scale (C-CSES) as a disease-specific instrument for patients with coronary heart disease (CHD) in mainland China.

Methods

The original English version of the CSES was translated into Chinese using a forward-backward translation approach. A convenience sample consisting of 224 Chinese patients with CHD were recruited from a university-affiliated hospital in Shiyan, China. The C-CSES and the General Self-efficacy Scale (GSES) were used in this study. The factor structure, convergent and discriminative validities, and internal consistency of the C-CSES were evaluated.

Results

The confirmatory factor analysis (CFA) supported a three-factor high-order structure of the C-CSES with model fit indexes (RMSEA = 0.084, CFI = 0.954, NNFI = 0.927, IFI = 0.954 and χ ² /df = 2.572). The C-CSES has good internal consistency with a Cronbach’s alpha of 0.926. The convergent validity of the C-CSES was established with significantly moderate correlations between the C-CSES and the Chinese version of the GSES (p < 0.001). The C-CSES has also shown good discriminative validity with significant differences of cardiac self-efficacy being found between patients with and without comorbidities of hypertension, diabetes, or heart failure.

Conclusion

The empirical data supported that the C-CSES is a valid and reliable disease-specific instrument for assessing the self-efficacy of Chinese patients with CHD.

Predictors of health-promoting behaviors in patients with coronary artery disease in the Iranian population

This study was carried out to determine the predictors of health-promoting behaviors (HPBs) in patients with coronary artery diseases (CAD) in the Iranian population. In this cross-sectional descriptive study, 250 eligible patients ages 42-80 years with a body mass index (BMI) between 18 and 45.7 kg/m² with CAD who were admitted to a cardiac hospital in Urmia, Iran participated. Valid questionnaires used the Health Promoting Lifestyle Profile-II (HPLP-II), Cardiac Self-Efficacy (CSE) and General Self-Efficacy (GSE) scales to assess HPBs, CSE and GSE, respectively. Fifty five percent of participants were men and mean (SD) age was 59 (12.1) years. Hierarchical multiple regression analysis indicated that CSE, GSE, education and BMI were the best predictors of HPBs, respectively. This model predicted 31% of HPB change (adjusted R²  = 0.31).Responsibility for health and spiritual growth motivates patients to apply HPBs. However, physical activity and stress management are least applied.

The effect of self-efficacy enhancement program on medication adherence among post-acute myocardial infarction

AIM AND BACKGROUND

Studies have reported that adherence to medications after hospital discharge for myocardial infarction is poor with about 12% to 20% of patients discontinue their medications six months after discharge. This study aimed to examine the effect of self-efficacy enhancement program on medication adherence in post-acute myocardial infarction patients.

METHODS

A total 44 patient with post-acute myocardial infarction were recruited from the in-patient department, Police General Hospital. The participants were random assigned into control group and experimental group. The control group received conventional care while the experimental group attended a four-week self-efficacy enhancement program, which included motivation, skill practice, and monitoring skills. The mean self-efficacy score between groups was assessed. The pill count was used to measure medication adherence. Correlations between self-efficacy and medication adherence were examined. Data were analyzed using descriptive statistic, Pearson's correlation, and t-test.

RESULTS

The mean score on medication adherence of the experiment group who attended the self-efficacy enhancement program was significantly greater than the control group (t=-2.77; df=21; p=0.01). The mean scores of self-efficacy between the experimental and control group were 35.73 (SD=4.11) and 35.41 (SD=3.78). The correlations between self-efficacy and medication adherence were significantly (r=1.00, p=0.00).

CONCLUSION

The effectiveness of self-efficacy enhancement program was effective in improving medication adherence in Thai post-acute myocardial infarction.

Knowledge of Coronary Heart Disease Risk Factors among a Community Sample in Oman: Pilot study

OBJECTIVES

The aim of this study was to assess the knowledge of Omani adults regarding conventional coronary heart disease (CHD) risk factors and to identify demographic variables associated with these knowledge levels.

METHODS

This descriptive cross-sectional pilot study was carried out among a convenience sample of 130 adults attending a health awareness fair held in a local shopping mall in Muscat, Oman, in November 2012. A modified version of the Heart Disease Facts Questionnaire in both English and Arabic was used to assess knowledge of CHD risk factors. Scores were calculated by summing the correct answers for each item (range: 0-21). Inadequate knowledge was indicated by a mean score of <70%. Descriptive and multivariate logistic regression analyses were performed to establish the participants' knowledge levels and identify associated demographic variables.

RESULTS

A total of 114 subjects participated in the study (response rate: 87.7%). Of these, 69 participants (60.5%) had inadequate mean CHD knowledge scores. Knowledge of CHD risk factors was significantly associated with body mass index (odds ratio [OR] = 0.739; P = 0.023), marital status (OR = 0.057; P = 0.036) and education level (OR = 9.243; P = 0.006).

CONCLUSION

Low knowledge levels of CHD risk factors were observed among the studied community sample in Oman; this is likely to limit the participants' ability to engage in preventative practices. These findings support the need for education programmes to enhance awareness of risk factors and prevention of CHD in Oman.

The Cardiac Self-Efficacy Scale, a useful tool with potential to evaluate person-centred care

BACKGROUND

Cardiac self-efficacy is a person's belief in his/her ability to manage the challenges posed by a coronary disease, and its role has been evaluated in several coronary populations using the Cardiac Self-Efficacy Scale (CSE Scale). Self-efficacy has an important role in person-centred care, however there is a lack of appropriate instruments that evaluate person-centred interventions.

AIM

The purpose of this study was to validate the CSE Scale by examining its psychometric properties as a first step in evaluating a person-centred care intervention in persons with acute coronary syndrome (ACS).

METHODS

The study sample consisted of 288 persons (72 women, 216 men) who completed the Swedish version of the CSE Scale two months after hospitalisation for an ACS event. Construct validity was psychometrically evaluated using confirmatory factor analysis. Additionally, convergent and discriminant validity were tested using correlation analyses.

RESULTS

The results revealed that the CSE Scale was represented by three dimensions (control symptoms, control illness and maintain functioning). The analyses also showed that the CSE Scale is suitable for providing a total summary score that represents a global cardiac self-efficacy dimension. Evaluation of convergent and discriminant validity showed the expected correlations.

CONCLUSION

The CSE Scale is a valid and reliable measure when evaluating self-efficacy in patients with ACS. It also seems to be a useful tool to promote person-centred care in clinical practice since it may offer useful guidance in the dialogue with the patient in the common creation of a personal health plan.

CHD knowledge and risk factors among Filipino-Americans connected to primary care services

PURPOSE

To examine the baseline knowledge and risk factors of coronary heart disease (CHD) among Filipino-Americans (FAs), and to identify the predictors of CHD knowledge.

DATA SOURCES

A convenience sample of 120 FAs recruited from three primary care clinics in Las Vegas, Nevada between May and July, 2010. Participants were asked about their demographic data and presence of CHD risk factors using the Demographics questionnaire. CHD knowledge was examined using the Heart Disease Fact questionnaire.

CONCLUSIONS

FAs connected to primary care services are knowledgeable about CHD. Predictors of CHD knowledge include: gender and education. CHD risk factors common to FAs include: hypertension, diabetes mellitus type 2, dyslipidemia, abdominal adiposity, overweight, lack of exercise, and smoking.

IMPLICATIONS FOR PRACTICE

Knowledge on CHD alone may not help prevent heart disease among FAs. Behavioral and cultural factors may play a major role in the development of CHD and CHD risk factors among FAs. NPs and other health care providers serve a vital role on health promotion, disease prevention, and management of patients. The use of the Neuman's systems model can serve as a guide when caring for FAs because of its emphasis in primary and secondary prevention interventions. Nurse practitioners must provide holistic and culturally sensitive care when managing their FA patients.

Cardiac self-efficacy and its predictors in patients with coronary artery diseases

AIMS AND OBJECTIVES

To investigate cardiac self-efficacy and its predictors among patients with coronary artery diseases.

BACKGROUND

Patients with coronary artery diseases must perform the health behaviour to prevent recurrent cardiac events. It has been already well known that self-efficacy is a vital factor in both initiating and maintaining health behaviours.

DESIGN

Descriptive correlational and cross-sectional survey design.

METHODS

Subjects were interviewed using structured study questionnaires. The data collected were statistically analysed by descriptive statistics and inferential statistics including the t-test, anova, Tukey's test, Pearson's correlation and hierarchical multiple regression analysis to determine the predictors of cardiac self-efficacy.

RESULTS

A convenience sample of 214 patients with coronary artery diseases was included. The mean age of subjects was 60·71 ± 10·07 years, and three-fourths were men. The overall model significantly explained 15·8% of variance in cardiac self-efficacy. Among predictors, occupation, diagnosis, body mass index, experience of receiving patient education and awareness of risk factors had statistically significant influences on cardiac self-efficacy.

CONCLUSIONS

Rather than disease knowledge, factors related to subject's perception were more likely to associate with cardiac self-efficacy. These findings might provide a theoretical basis to develop nursing interventions for enhancing cardiac self-efficacy of patients with coronary artery diseases.

RELEVANCE TO CLINICAL PRACTICE

Clinical nurses taking care of patients with coronary artery diseases should consider the patients' perception on their coronary artery diseases including experience of receiving patient education, and awareness of risk factors in encouraging the cardiac self-efficacy to promote the health behaviours for the secondary prevention of coronary artery diseases.

Predischarge education improves adherence to a healthy lifestyle among Jordanian patients with acute coronary syndrome

Risk factor reduction and modification of patient lifestyle have become the focus of secondary prevention and cardiac rehabilitation programs. Considering the scarcity of resources in developing countries, nurses can potentially provide great benefit to acute coronary syndrome patients by utilizing hospital time to teach the patients how to lower their risk for recurrence and adopt healthier lifestyles after discharge. The purpose of this study was to identify the effectiveness of a predischarge education on acute coronary syndrome patients' lifestyles. Quasi-experimental pretest-post-test design was used. The patients assigned to the experimental group were offered predischarge education that stimulates lifestyle modification and adoption of a healthier lifestyle. The experimental group scored significantly higher than the control group in three lifestyle components - health responsibilities, nutrition, and interpersonal relations. In conclusion, predischarge education helps motivate acute coronary syndrome patients to adhere to a healthy lifestyle postdischarge. Therefore, nurses must be educated and prepared to be qualified health educators, and health education should continue as one of the most important daily nursing practices, thus it is invested in the preparation of acute coronary patients' discharge plan.