Nurse-led interventions have imparted positive outcomes in response to ACS symptoms among coronary patients. Therefore, nurses should take the initiative in educating patients to minimize delay in symptom interpretation and seeking early treatment.

Objective: Female gender is a major barrier to complete cardiac rehabilitation program (CRP) after acute coronary syndrome (ACS). Women require significant social support to promote compliance and the ability to cope with CRP attendance. This systematic review of qualitative studies aimed to explore the social support among women coping with CRP attendance after being diagnosed with ACS.Methods: Articles were searched through CINAHL, Science Direct and PubMed using the following terms: women, acute coronary syndrome, coping, social support and cardiac rehabilitation. Results: A total of 6 articles were selected based on eligibility criteria. Thematic analysis was used to analyze the data using line to line coding into descriptive themes, interpreting further to generate new sights. The three most common themes on social support for women attending the CRP were family support, female as the primary caregiver role in the family, and peer support. Most women who perceived themselves as the primary caregiver role in the family have negatively impacted their ability to cope with CRP attendance fully. On the other hand, encouraging family and peer support positively improve their coping mechanism for attending the CRP, leading to better compliance. Conclusion: The study suggests that women with ACS appreciate the support from their family as a vital role as a coping mechanism towards their attendance to CRP. Health care providers can teach the importance of social support among women after discharge to cope with CRP attendance.

Little is known about the changes in perception of illness among patients with the acute coronary syndrome (ACS) during cardiac rehabilitation programme (CRP). The purpose of this study is to determine changes in perception of illness with ACS patients during CRP to evaluate the association of patients’ characteristics with the perception of illness at the end of Phase II of CRP. A descriptive longitudinal study was conducted among 450 patients who attended 8-weeks of Phase II CRP at 2 public hospitals in Malaysia and perception of illness was assessed using Brief Illness Perception Questionnaire (BIPQ). The assessment was conducted before Phase II (T0), during the 4th session (T1), and at the end of right after the 8th session (T2). One-way repeated measures of ANOVA analysed the changes of perception at T1 and T2 while logistic regression analysis evaluated the association of patients’ characteristics with the perception of illness at T2. Perception of illness changed during and after CRP from T0 to T1, and T1 to T2 (p<0.001). The patient viewed ACS as an illness that changed from being more acute to a chronic condition as the sessions progressed. Previous history of acute myocardial infarction (OR= 2.380, 95%CI 1.46, 5.49) and angioplasty intervention were both found to be associated with the perception of illness (OR=3.857, 95% CI 1.55, 9.61). Perception of illness changed during CRP and these changes are associated with patients’ previous history of cardiac events. Phase II can be viewed as the second window of opportunity for healthcare professionals to intervene early in modifying the perception of illness.