A randomized controlled trial to reduce delay in older adults seeking help for symptoms of acute myocardial infarction

Tullmann, Dorothy; Haugh, Kathy Henley; Dracup, Kathleen; Bourguignon, Cheryl

doi:10.1002/nur.20245

Cited by 27 publications

(44 citation statements)

References 47 publications

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“…Five of these were based on Leventhal's Self-Regulatory Model of Illness Behaviour [7,8,[16][17][18]. As most of these researchers reported successful intervention outcomes [7,8,16,18], the use of Leventhal's Self-Regulatory Model of Illness Behaviour in this study substantiates the effectiveness of the intervention.…”

Section: The Theoretical Frameworksupporting

confidence: 61%

“…The majority of previous interventions that targeted knowledge, attitudes and beliefs about ACS were underpinned by a theoretical framework [7,8,[16][17][18]20]. Five of these were based on Leventhal's Self-Regulatory Model of Illness Behaviour [7,8,[16][17][18]. As most of these researchers reported successful intervention outcomes [7,8,16,18], the use of Leventhal's Self-Regulatory Model of Illness Behaviour in this study substantiates the effectiveness of the intervention.…”

Section: The Theoretical Frameworksupporting

confidence: 61%

“…Theoretically-based education is considered superior to its non-theory based counterpart [34][35][36]. The majority of previous interventions that targeted knowledge, attitudes and beliefs about ACS were underpinned by a theoretical framework [7,8,[16][17][18]20]. Five of these were based on Leventhal's Self-Regulatory Model of Illness Behaviour [7,8,[16][17][18].…”

Section: The Theoretical Frameworkmentioning

confidence: 99%

“…To date, eight interventions aimed to improve knowledge, attitudes or beliefs about ACS [7,8,14,[16][17][18][19][20]. A summary of these interventions are outlined in Table 1.…”

Section: Introductionmentioning

confidence: 99%

“…Six of the eight interventions reported significant improvements in knowledge of ACS symptoms [7,8,14,16,18,19]. Of the three researchers who reported on attitudes and beliefs [7,8,18], one researcher [8] reported significant improvement in attitudes, while two researchers [8,18] reported significant improvements in beliefs, following their intervention. While previous interventions showed promising results, none of these have been conducted in Europe.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Improving knowledge, attitudes and beliefs about acute coronary syndrome through an individualized educational intervention: A randomized controlled trial

O’Brien

McKee

Mooney

et al. 2014

Patient Education and Counseling

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CitationImproving knowledge, attitudes and beliefs about acute coronary syndrome through an individualized educational intervention: A randomized controlled trial. Methods: This multi-site, randomized controlled trial was conducted on 1947 patients with a diagnosis of ACS. Both groups received usual in-hospital education.Participants randomized to the intervention group received a 40-minute one to one individualized education session, delivered using motivational interviewing techniques. The intervention was reinforced one month and six months later.Knowledge, attitudes and beliefs were measured using the ACS Response Index. A total of 1,136 patients (control, n=551; intervention, n=585) completed the questionnaire at baseline, 3 and 12 months. Data were analysed using repeated measures analysis of variance. Ethical approval was obtained. Results:There was a significant effect of the intervention on mean knowledge (p<0.001), attitude (p=0.003) and belief (p<0.001) scores at 3 and 12 months. Conclusion:Ensuring patients retain information post education has always been difficult to attain. This study demonstrated that patient education using motivational interviewing techniques and an individualized approach has the potential to alter knowledge, attitudes and beliefs about ACS among a high risk population.Practice Implications: This relatively short, simple and effective educational intervention could be delivered by nurses in multiple settings.

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Section: The Theoretical Frameworksupporting

confidence: 61%

Section: The Theoretical Frameworksupporting

confidence: 61%

Section: The Theoretical Frameworkmentioning

confidence: 99%

“…To date, eight interventions aimed to improve knowledge, attitudes or beliefs about ACS [7,8,14,[16][17][18][19][20]. A summary of these interventions are outlined in Table 1.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Improving knowledge, attitudes and beliefs about acute coronary syndrome through an individualized educational intervention: A randomized controlled trial

O’Brien

McKee

Mooney

et al. 2014

Patient Education and Counseling

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Effects of a Narrative-Based Psychoeducational Intervention to Prepare Patients for Responding to Acute Myocardial Infarction

Yan

et al. 2022

JAMA Netw Open

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ImportanceDespite decades of educational efforts, patients’ prolonged delays in seeking care for symptoms of acute myocardial infarction (AMI) remain the greatest obstacle to successful management of the condition.ObjectiveTo compare the effects of a narrative-based psychoeducational intervention with a didactic educative approach on AMI survivors’ intention to seek care for AMI symptoms and on AMI knowledge.Design, Setting, and ParticipantsA multisite randomized clinical trial recruited community-dwelling patients aged 18 years or older with a history of AMI from 4 hospitals in Hong Kong from January 1, 2018, to January 22, 2021, and followed up participants for 1 year.InterventionsAn 8-week narrative-based psychoeducational intervention aimed to create a vivid cognitive experience of complex decision-making and modeled desirable behavioral changes through nurse-led, interactive video sessions using model patients. The control group received 4 nurse-led sessions comprising education about AMI and care seeking delivered using a didactic approach.Main Outcomes and MeasuresThe primary outcome was the behavioral intention between the 2 groups, reflected by participants’ attitudes and beliefs about care seeking for AMI measured using the Acute Coronary Syndrome Response Index—Chinese version. The secondary outcome was AMI knowledge.ResultsSix hundred and eight participants (mean [SD] age, 67.2 [8.3] years; 469 [77.1%] male) were randomized to either the narrative-based psychoeducation group (n = 304) or the didactic education group (n = 304). The psychoeducational intervention group reported greater positive changes than the control group in their attitudes (β = −1.053 [95% CI, −1.714 to −0.391]; P &lt; .001) and beliefs (β = −0.686 [95% CI, −1.354 to −0.180]; P = .04) toward care seeking at the 3-month follow-up, and the difference was sustained at 12 months for both attitudes (β = −0.797 [95% CI, −1.477 to −0.117]; P = .02) and beliefs (β = −0.692 [95% CI, −1.309 to −0.012]; P = .047). There were no significant differences in AMI knowledge between the 2 study groups at the 3-month and 12-month time points.Conclusions and RelevanceThe results of this randomized clinical trial found that a novel approach of narrative-based psychoeducation was effective in improving patients’ behavioral intention to seek care for AMI symptoms. Longer-term follow-up to evaluate actual care-seeking behavior and clinical outcomes in patients with AMI is warranted to determine the sustained effects of this intervention.Trial RegistrationChiCTR Identifier: ChiCTR-IIC-17010576

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Care-seeking decisions for worsening symptoms in heart failure: a qualitative metasynthesis

2015

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Over 50 % of heart failure (HF) patients delay seeking help for worsening symptoms until these reach acute levels and require emergency hospitalisation. This metasynthesis aimed to identify and explore factors influencing timely care-seeking in patients with HF. Electronic databases searched were MEDLINE, Embase, and CINAHL. Studies were included if they were peer-reviewed journal articles, written in English, and reported perspectives of HF patients following qualitative data collection and analysis. Forty articles underwent analysis following the approach of Thomas and Harden. Leventhal's self-regulatory model (SRM) was used to organise the literature. Much of the literature fits within the SRM; however, this model did not account for all factors that influence patients' care-seeking for worsening symptoms. Factors not accounted for included patients' appraisals of previous care-seeking experiences, perceived system and provider barriers to accessing care, and the influence of external appraisals. When added to factors already represented in the model, such as misattribution of symptoms, not identifying with HF diagnosis, cognitive status, lack of understanding information provided, adaptation to symptoms, and emotional responses, a more comprehensive account of patients' decision-making was revealed. This metasynthesis identified factors, as yet unaccounted for, in a prominent model, and has suggested a more comprehensive framework for addressing care-seeking in HF patients. This information can be used to tailor education, communication, and service initiatives to improve HF patients' responses to worsening symptoms and target those most at risk of delay.

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A randomized controlled trial to reduce delay in older adults seeking help for symptoms of acute myocardial infarction

Cited by 27 publications

References 47 publications

Improving knowledge, attitudes and beliefs about acute coronary syndrome through an individualized educational intervention: A randomized controlled trial

Improving knowledge, attitudes and beliefs about acute coronary syndrome through an individualized educational intervention: A randomized controlled trial

Effects of a Narrative-Based Psychoeducational Intervention to Prepare Patients for Responding to Acute Myocardial Infarction

Care-seeking decisions for worsening symptoms in heart failure: a qualitative metasynthesis

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