Effect of Couple Education on Spouses' Anxiety and Treatment Adherence in Patients with Acute Coronary Syndrome Admitted to Cardiac Intensive Care Unit

Abstract

Background: Reducing the anxiety in spouses suffering from cardiovascular diseases is essential for themselves and improving treatment outcomes by increasing adherence to treatment and medication. Objectives: This study aimed to examine the effect of couple education on spouses' anxiety, and treatment adherence in patients with acute coronary syndrome (ACS) admitted to the cardiac intensive care unit. Methods: This quasi-experimental study was conducted on 70 couples, including the spouses and patients with ACS admitted to the cardiac intensive care units of Khatam al-Anbia and Ali Ibn Abitaleb hospitals of Zahedan University of Medical Sciences in 2021. The participants were selected using convenience sampling and randomly divided into intervention and control groups. The participants in the intervention group attended three training sessions for three consecutive days based on their clinical diagnosis and treatment following the educational table of content. The instructions in the training sessions were provided to the patients and their spouses for 40 to 60 minutes in the clinic. In contrast, the patients in the control group received only routine ward care. Twelve weeks after the intervention, data were collected using two self-report instruments, including the Medication Adherence Scale and Spielberger State-Trait Anxiety Inventory. The collected data were analyzed by SPSS software (version 22) using paired-samples t-test, independent samples t-test, chi-square test, and analysis of covariance (ANCOVA). Results: The ANCOVA showed that after the couple education intervention, the mean anxiety score of the spouses of ACS patients in the intervention group was significantly lower than the score of the participants in the control group (P = 0.001). Moreover, the mean score of patients' treatment adherence in the intervention group (58.54 ± 5.00) was significantly higher than that of the control group (39.05 ± 9.11) (P = 0.001). Conclusions: The present study indicated that couple education reduces anxiety in the spouses of ACS patients and increases treatment adherence in the patients. Thus, integrating interventions such as couple education in the rehabilitation programs for ACS patients can improve treatment adherence in patients and reduce anxiety in spouses.

The Effect of Couple Training on Treatment Adherence of Breast Cancer Patients Undergoing Chemotherapy

“…Hemmati Maslakpak et al showed that family-based care can increase treatment adherence and reduce fasting blood sugar and glycosylated hemoglobin in diabetic patients (31). Furthermore, Rafeie et al showed that couple training, in addition to reducing the anxiety level of the spouses of patients with acute coronary syndrome, increases treatment adherence in patients (25). Although the research samples and procedures in their study differed from the present study, the patients needed long-term adherence to the treatment regimen due to the chronic nature of both diseases, and the intervention improved their adherence.…”

“…The sample size was estimated as 4 persons in each group based on the mean treatment adherence score in a similar study (25) and with a 95% confidence interval and 95% test power using the following formula (26). However, to ensure sample adequacy and account for any probable dropout, the sample size was 40 persons in each group (80 persons total).…”