Continuous Care Model and the Self-Management in Post-Myocardial Infarction Patients: A Randomized Controlled Trial

Abstract

Background: Self-management after myocardial infarction is fundamental to effective medical treatment. Objectives: The current study aimed to investigate the effects of applying the continuous care model on self-management of a sample of Iranian patients with post-myocardial infarction. Methods: Sixty hospitalized patients were randomly allocated into control (n = 30) and intervention (n = 30) groups. Before the intervention and at the end of it, self-management of both groups was evaluated by chronic disease self-management questionnaire. The continuous care model was performed for the intervention group for three months. The data were analyzed by SPSS version 16. In addition to descriptive statistical tests, Chi-square, the exact Fisher, Willcoxon and Mann-Whitney, and analysis of covariance (ANCOVA) tests were used. The significant level was set at P < 0.05. Results: There was no significant difference between the two groups in terms of sub-dimensions of self-management scores before the intervention (P > 0.05). At the end of the intervention, in all self-management sub-dimensions expect for shortness of breath, the status of intervention group improved significantly more than that of the control group (P < 0.005). Moreover, mean of changes in all sub-dimensions of self-management showed no significant difference, but fatigue and health care utilization between the two groups had significant difference. Conclusions: The continuous care model can be considered as a useful tool to improve patients' self-management after myocardial infarction.

The effect of the Continuous Care Model on treatment adherence in patients with myocardial infarction: a randomised controlled trial

“…Our results showed the CCM increased the physical activity adherence of patients with MI. In line with the current study, the implementation of a follow-up care model increased the physical activity adherence in patients with MI (Akbari et al., 2015, 2017), heart failure (Sadeghi et al., 2009) and type 2 diabetes (Shahsavari and Foroghi, 2015). A study by Redfern et al.…”

“…Our results showed the CCM increased the physical activity adherence of patients with MI. In line with the current study, the implementation of a follow-up care model increased the physical activity adherence in patients with MI (Akbari et al, 2015(Akbari et al, , 2017, heart failure (Sadeghi et al, 2009) and type 2 diabetes (Shahsavari and Foroghi, 2015). A study by Redfern et al on the survivors of acute coronary syndrome showed that a face-to-face counselling session for 1 h and four phone calls of 10 min in three months improved physical activity for more than a year (Redfern et al, 2009).…”

Theory‐based nursing interventions in adults with coronary heart disease: A systematic review and meta‐analysis of randomized controlled trials

“…Several studies have suggested that theory-based nursing interventions in CHD management had success in decreasing blood lipid concentrations, blood pressure, and re-hospitalization rate, and may enhance medication adherence, better adaptation to diet modifications and physical activity recommendations, and thus improved QoL (Faroughi et al, 2021;Mohammadpour et al, 2015;Turan Kavradim & Canli Ozer, 2020;Yildiz & Kasikci, 2020). (Akbari et al, 2017;Akhlaghi et al, 2021;Javadzade et al, 2018). However, to the best of our knowledge, no systematic review or meta-analysis has examined the effects of theory-based nursing interventions in CHD management, and no firm conclusion on this issue has been made so far.…”

“…Theory‐based nursing interventions play a vital role in changing unhealthy behaviors (Smith & Parker, 2015). Considering previous clinical studies in CHD management, while some studies were not conducted based on a specific nursing theory, some of those directly implemented nursing theories like Pender's health promotion model (HBM), transtheoretical model (TTM), Orem's self‐care deficit theory, Roy's adaptation model (RAM), and continuous care model (CCM; Akbari et al,2017 ; Faroughi et al, 2021; Turan Kavradim & Canli Ozer, 2020; Yildiz & Kasikci, 2020; Zhu et al, 2014). The HBM includes several concepts like perceived susceptibility, seriousness, benefits, and barriers to adopting a behavior, tips to take an action, and self‐efficacy that anticipates why people will act to control diseases and related problems (Champion & Skinner, 2008).…”

“…The RAM aims to develop coping mechanisms for certain external and internal environmental changes to maintain adaptation and promote health (Turan Kavradim & Canli Ozer, 2020). The CCM contains orientation, sensitization, control, and evaluation stages that aid in developing and maintaining a flexible, and ongoing care connection between the nurses and patients (Akbari et al,2017). Several studies have suggested that theory‐based nursing interventions in CHD management had success in decreasing blood lipid concentrations, blood pressure, and re‐hospitalization rate, and may enhance medication adherence, better adaptation to diet modifications and physical activity recommendations, and thus improved QoL (Faroughi et al, 2021; Mohammadpour et al, 2015; Turan Kavradim & Canli Ozer, 2020; Yildiz & Kasikci, 2020).…”