J Korean Acad Nurs.  2017 Dec;47(6):756-769. 10.4040/jkan.2017.47.6.756.

The Effects of Smart Program for Patients Who Underwent Percutaneous Coronary Intervention (SP-PCI) on Disease-Related Knowledge, Health Behavior, and Quality of Life: A Non-Randomized Controlled Trial

• Lee J
• Lee H

• KMID: 2408142
• DOI: http://doi.org/10.4040/jkan.2017.47.6.756

Abstract

PURPOSE
To identify the effects of a smart program for the patients who underwent percutaneous coronary intervention (SP-PCI) on coronary disease-related knowledge, health behaviors, and quality of life.
METHODS
A nonequivalent control group with a non-synchronized design was utilized and 48 participants (experimental=22, control=26) were recruited from a university hospital in Gyeongsang area from May to December, 2016. The 12-week SP-PCI consisted of self-study of health information using smart phone applications (1/week), walking exercise (>5/week) using smart band, feedback using Kakao talk (2/week), and telephone counseling (1/week). Patients in the control group received usual care from their primary health care providers and a brief health education with basic self-management brochure after the PCI. Data were analyzed using the SPSS 21.0 program through descriptive statistics, χ2 test, and t-test.
RESULTS
After the 12-week SP-PCI, the experimental group showed higher levels of coronary disease-related knowledge (t=2.43, p=.019), heart-related health behaviors (t=5.96, p < .001), regular exercise (Z=-4.47, p < .001), and quality of life-MCS (t=3.04, p=.004) and showed lower levels of stress (Z=-3.53, p < .001) and sodium intake (t=-4.43, p < .001) than those in the control group. There were no significant group differences in medication adherence and food intake in total energy, lipids, and cholesterol.
CONCLUSION
The suggested SP-PCI provided easy access and cost-effective intervention for patients after PCI and improved their knowledge of the disease, performance of health behaviors, and quality of life. Further study with a wider population is needed to evaluate the effects of SP-PCI on disease recurrence and quality of life for patients after PCI.

Keyword

Percutaneous coronary intervention; Smartphone; Knowledge; Health behavior; Quality of life

MeSH Terms

Cholesterol
Counseling
Eating
Health Behavior*
Health Education
Humans
Medication Adherence
Pamphlets
Percutaneous Coronary Intervention*
Primary Health Care
Quality of Life*
Recurrence
Self Care
Smartphone
Sodium
Telephone
Walking
Cholesterol
Sodium

Figure

• 

  Figure 1. Flow chart of the study.

Reference

References

1. Konstance RP, Eisenstein EL, Anstrom KJ, Shaw LK, Califf RM, Harrington RA, et al. Outcomes of second revasculariza-tion procedures after stent implantation. Journal of Medical Systems. 2008; 32(2):177–186. https://doi.org/10.1007/s10916-007-9120-x.

2. Eckel RH, Jakicic JM, Ard JD, de Jesus JM, Miller NH, Hubbard VS, et al. 2013 AHA/ACC guideline on lifestyle management to reduce cardiovascular risk: A report of the American College of Cardiology/American Heart Association task force on practice guidelines. Journal of the American College of Cardiology. 2014; 63(25):2960–2984. https://doi.org/10.1016/j.jacc.2013.11.003.

3. Höfer S, Benzer W, Oldridge N. Change in health-related quality of life in patients with coronary artery disease predicts 4-year mortality. International Journal of Cardiology. 2014; 174(1):7–12. https://doi.org/10.1016/j.ijcard.2014.03.144.

4. Park IS, Song R, Ahn S, So HY, Kim HL, Joo KO. Factors explaining quality of life in individuals with coronary artery disease. Journal of Korean Academy of Nursing. 2008; 38(6):866–873. https://doi.org/10.4040/jkan.2008.38.6.866.

5. Won MH. Effect of education and counselling-based cardiac rehabilitation program on cardiovascular risk, health behavior and quality of life in elderly with coronary artery disease. Journal of the Korea Contents Association. 2015; 15(6):303–313. https://doi.org/10.5392/JKCA.2015.15.06.303.

6. Stewart R, Held C, Brown R, Vedin O, Hagstrom E, Lonn E, et al. Physical activity in patients with stable coronary heart disease: An international perspective. European Heart Journal. 2013; 34(42):3286–3293. https://doi.org/10.1093/eurheartj/eht258.

7. Shin N, Kang Y. The relationships among health locus of control and resilience, social support and health promoting behavior in patients with newly diagnosed coronary artery diseases. Korean Journal of Adult Nursing. 2015; 27(3):294–303. https://doi.org/10.7475/kjan.2015.27.3.294.

8. Mosleh SM, Darawad M. Patients’ adherence to healthy behavior in coronary heart disease: Risk factor management among Jordanian patients. Journal of Cardiovascular Nursing. 2014; 30(6):471–478. https://doi.org/10.1097/jcn.0000000000000189.

9. Nolan MT, McKee G. Is knowledge level of coronary heart disease and risk factors among post-percutaneous coronary intervention patients adequate? Journal of Cardiovascular Nursing. 2016; 31(3):E1–E9. https://doi.org/10.1097/JCN.0000000000000291.

10. Song RY, Park MK, Cheong JO, Park JH, Seong IW. Effects of Tai Chi exercises on cardiovascular risks, recurrence risk, and quality of life in patients with coronary artery disease. Korean Journal of Adult Nursing. 2013; 25(5):515–526. https://doi.org/10.7475/kjan.2013.25.5.515.

11. Kang KJ, Song MS. Development and evaluation of motivational enhancement therapy for patients with coronary artery disease. Journal of Korean Clinical Nursing Research. 2010; 16(2):5–16.

12. Lee KS, Sung KM. Effects of an individualized cardiac rehabilitation education program on knowledge about coronary artery disease, compliance of sick role, and vascular health status in patients of percutaneous coronary intervention. Korean Journal of Rehabilitation Nursing. 2015; 18(2):135–144. https://doi.org/10.7587/kjrehn.2015.135.

13. Zhang H, Jiang Y, Nguyen HD, Poo DC, Wang W. The effect of a smartphone-based coronary heart disease prevention (SBCHDP) programme on awareness and knowledge of CHD, stress, and cardiac-related lifestyle behaviours among the working population in Singapore: A pilot randomised controlled trial. Health and Quality Life Outcomes. 2017; 15(1):49. https://doi.org/10.1186/s12955-017-0623-y.

14. Chow CK, Redfern J, Hillis GS, Thakkar J, Santo K, Hackett ML, et al. Effect of lifestyle-focused text messaging on risk factor modification in patients with coronary heart disease: A randomized clinical trial. JAMA. 2015; 314(12):1255–1263. https://doi.org/10.1001/jama.2015.10945.

15. Antypas K, Wangberg SC. An internet- and mobile-based tailored intervention to enhance maintenance of physical activity after cardiac rehabilitation: Short-term results of a randomized controlled trial. Journal of Medical Internet Research. 2014; 16(3):e77. https://doi.org/10.2196/jmir.3132.

16. Varnfield M, Karunanithi M, Lee CK, Honeyman E, Arnold D, Ding H, et al. Smartphone-based home care model improved use of cardiac rehabilitation in postmyocardial infarction patients: Results from a randomised controlled trial. Heart. 2014; 100(22):1770–1779. https://doi.org/10.1136/heartjnl-2014-305783.

17. Song KJ. The effects of self-efficacy promoting cardiac rehabilitation program on self-efficacy, health behavior, and quality of life. Journal of Korean Academy of Nursing. 2003; 33(4):510–518. https://doi.org/10.4040/jkan.2003.33.4.510.

18. Cohen J. A power primer. Psychological Bulletin. 1992; 112(1):155–159. https://doi.org/10.1037/0033-2909.112.1.155.

19. Kim IJ. A study for the level of knowledge and compliance of medical regimen of the patient with coronary artery disease [masters’thesis]. Seoul: Yonsei University;1991. p. 1–56.

20. Kim NH, Park OJ. A study on coronary artery restenosis, knowledge related to disease and compliance with sick role behavior in the patients received follow-up coronary angiogram after coronary intervention. Journal of Chonnam Research Institute of Nursing Science. 2009; 14(1):45–54.

21. Walker SN, Sechrist KR, Pender NJ. The health-promoting lifestyle profile: Development and psychometric characteristics. Nursing Research. 1987; 36(2):76–81. https://doi.org/10.1097/00006199-198703000-00002.

22. Song R, June KJ, Kim CG, Jeon MY. Comparisons of motivation, health behaviors, and functional status among elders in residential homes in Korea. Public Health Nursing. 2004; 21(4):361–371. https://doi.org/10.1111/j.0737-1209.2004.21410.x.

23. Morisky DE, Ang A, Krousel-Wood M, Ward HJ. Predictive validity of a medication adherence measure in an outpatient setting. Journal of Clinical Hypertension (Greenwich). 2008; 10(5):348–354. https://doi.org/10.1111/j.1751-7176.2008.07572.x.

24. Linn MW. A Global Assessment of Recent Stress (GARS) scale. International Journal of Psychiatry in Medicine. 1985-1986; 15(1):47–59. https://doi.org/10.2190/XP8N-RP1W-YE2B-9Q7V.

25. Koh KB, Park JK. Validity and reliability of the Korean version of the global assessment of recent stress scale. Korean Journal of Psychosomatic Medicine. 2000; 8(2):201–211.

26. Ministry of Health and Welfare & The Korean Nutrition Society. Summary of 2015 dietary reference intakes for Koreans [Internet]. Seoul: Joung H;c2015. [cited 2017 Mar 15]. Available from:. http://www.kns.or.kr/FileRoom/FileRoom_view.asp?mode=mod&restring=%252FFileRoom%252FFileRoom.asp%253Fxsearch%253D0%253D%253Dxrow%253D10%253D%253DBoardID%253DKdr%253D%253Dpage%253D1&idx=79&page=1&BoardID=Kdr&xsearch=1&cn_search.

27. Ware J Jr, Kosinski M, Keller SD. A 12-item short-form health survey: Construction of scales and preliminary tests of reliability and validity. Medical Care. 1996; 34(3):220–233. https://doi.org/10.1097/00005650-199603000-00003.

28. Jeong HS, Kim HS, Yoo YS, Moon JS. Effects of cardiac rehabilitation teaching program on knowledge level and compliance of health behavior for patients with myocardial infarction. Journal of Korean Academy of Nursing. 2002; 32(1):50–61. https://doi.org/10.4040/jkan.2002.32.1.50.

29. Shephard RJ, Franklin B. Changes in the quality of life: A major goal of cardiac rehabilitation. Journal of Cardiopulmonary Rehabilitation. 2001; 21(4):189–200.