Intensive nurse-led follow-up in primary care to improve self-management and compliance behaviour after myocardial infarction

Abstract

Abstract

Aims and objectives To assess the effects of intensive follow-up by primary care nurses on cardiovascular disease self-management and compliance behaviours in post-myocardial infarction patients.

Background Although cardiovascular disease prevention and cardiac rehabilitation take place in hospital settings, a nurse-led approach is necessary in primary care during the first few months after a myocardial infarction. Therefore, it is important to assess self-management of cardiovascular disease and levels of compliance with the prescribed diet, physical activity, and medication. To facilitate patients’ self-efficacy, the use of health education tools such as a heart-healthy self-care notebook can be helpful.

Design The study used a multicentre, quasi-experimental, pre-post design without a control group.

Methods Patients with acute coronary syndrome from 40 healthcare facilities were included in the study. A total of 212 patients and 59 nurses participated in a programme including 11 interventions during the first 12-18 months after myocardial infarction. The following Nursing Outcomes Classification outcomes were assessed at baseline and at the end of the intervention: Self-management: Cardiac Disease (1617) and Compliance Behaviour: Prescribed Diet (1622), Compliance Behaviour: Prescribed Activity (1632), and Compliance Behaviour: Prescribed Medication (1623). Marjory Gordon’s functional health patterns and a self-care notebook were used in each intervention. Pre-post intervention means were compared using Student’s t-tests for related samples. The results of the study are reported in compliance with the TREND Statement.

Results A total of 132 patients completed the intervention. Significant improvement in compliance with diet, physical activity, and prescribed medication was observed at pre-post follow-up, as well as in most indicators in the Self-management: Cardiac Disease outcome.

Conclusion Intensive, immediate follow-up after myocardial infarction improves compliance behaviours and self-management of heart disease. A combined self-care and family care approach should be encouraged to empower post-myocardial infarction patients.