Department of Nursing and Stomatology, Faculty of Health Sciences, Rey Juan Carlos University, Madrid, Spain.
Nursing Research Group Cardiovascular Care, Society of Family and Community Nursing (SEMAP), Madrid, Spain.
Nurs Open. 2023 Aug;10(8):5211-5224. doi: 10.1002/nop2.1758. Epub 2023 Apr 21.
To assess the effects of intensive follow-up by primary care nurses on cardiovascular disease self-management and compliance behaviours after myocardial infarction.
Although cardiovascular disease prevention and cardiac rehabilitation take place in hospital settings, a nurse-led approach is necessary in primary care during the first few months after a myocardial infarction. Therefore, it is important to assess self-management of cardiovascular disease and levels of compliance with the prescribed diet, physical activity, and medication.
The study used a multicentre, quasi-experimental, pre-post design without a control group.
Patients with acute coronary syndrome from 40 healthcare facilities were included in the study. A total of 212 patients participated in a programme including 11 interventions during the first 12-18 months after myocardial infarction. The following Nursing Outcomes Classification (NOC) outcomes were assessed at baseline and at the end of the intervention: Self-management: Cardiac Disease (1617) and Compliance Behaviour: Prescribed Diet (1622), Compliance Behaviour: Prescribed Activity (1632), and Compliance Behaviour: Prescribed Medication (1623). Marjory Gordon's functional health patterns and a self-care notebook were used in each intervention. Pre-post intervention means were compared using Student's t-tests for related samples. The results of the study are reported in compliance with the TREND Statement.
A total of 132 patients completed the intervention. The indicators for each NOC outcome and the variations in scores before and after the intensive follow-up showed a statistically significant improvement (p-value = 0.000). Compliance Behaviour: Prescribed Diet (pre = 3.7; post = 4.1); Compliance Behaviour: Prescribed Activity (pre = 3.9; post = 4.3); Compliance Behaviour: Prescribed Medication (pre = 3.9; post = 4.7).
Intensive, immediate follow-up after myocardial infarction improves compliance behaviours and self-management of heart disease. A combined self-care and family care approach should be encouraged to empower post-myocardial infarction patients. To facilitate patients' self-efficacy, the use of health education tools such as a cardiovascular self-care notebook can also be helpful.
This study highlights the benefits of intensive, protocolised, comprehensive patient follow-up in primary care during the first few months after an acute myocardial infarction (AMI). Primary care nurses train patients in cardiovascular self-care.
Patients were not involved in either the design or the carrying out of the study. However, at the end of the study, they participated in an evaluation process about the utility of the research study and their satisfaction with it. This process was carried out using an ad hoc survey consisting of 10 questions assessing the nursing care and follow-up inputs that were received.
评估初级保健护士对心肌梗死后心血管疾病自我管理和依从行为的强化随访的效果。
尽管心血管疾病预防和心脏康复在医院环境中进行，但在心肌梗死后的头几个月，初级保健中需要护士主导的方法。因此，评估心血管疾病的自我管理和遵守规定饮食、身体活动和药物的水平非常重要。
该研究采用了多中心、准实验、前后设计，没有对照组。
来自 40 个医疗保健机构的急性冠状动脉综合征患者被纳入研究。共有 212 名患者参加了一项计划，其中包括心肌梗死后 12-18 个月内的 11 项干预措施。在基线和干预结束时评估了以下护理结局分类 (NOC) 结果：自我管理：心脏疾病 (1617) 和依从行为：规定饮食 (1622)、依从行为：规定活动 (1632) 和依从行为：规定药物 (1623)。在每个干预中都使用了 Marjory Gordon 的功能健康模式和自我护理笔记本。使用相关样本学生 t 检验比较前后干预的平均值。该研究的结果按照 TREND 声明报告。
共有 132 名患者完成了干预。每个 NOC 结果的指标以及强化随访前后的评分变化均显示出统计学上的显著改善（p 值=0.000）。依从行为：规定饮食（前=3.7；后=4.1）；依从行为：规定活动（前=3.9；后=4.3）；依从行为：规定药物（前=3.9；后=4.7）。
心肌梗死后的强化、即时随访可改善遵医嘱行为和心脏病的自我管理。应鼓励综合自我护理和家庭护理方法，为心肌梗死后患者提供支持。为了增强患者的自我效能，使用心血管自我护理笔记本等健康教育工具也可能有所帮助。
本研究强调了在急性心肌梗死后的头几个月内，初级保健中进行强化、规范化、全面的患者随访的益处。初级保健护士培训患者进行心血管自我护理。
患者既没有参与研究的设计，也没有参与研究的实施。然而，在研究结束时，他们参与了一个关于研究实用性和他们满意度的评估过程。该过程使用一个由 10 个问题组成的特定调查进行，评估他们收到的护理和随访投入。
