Educational program for coronary artery disease patients: results after one year

Arantes, Eliana de Cássia; Dessotte, Carina Aparecida Marosti; Dantas, Rosana Aparecida Spadoti; Rossi, Lidia Aparecida; Furuya, Rejane Kiyomi

doi:10.1590/0034-7167-2017-0280

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Revista Brasileira de Enfermagem

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Sumário

RESEARCH • Rev. Bras. Enferm. 71 (6) • Nov-Dec 2018 • https://doi.org/10.1590/0034-7167-2017-0280 copy

Educational program for coronary artery disease patients: results after one year

Programa educativo para pacientes con enfermedad arterial coronaria: resultados después de un año

Authorship SCIMAGO INSTITUTIONS RANKINGS

ASTRACT

Objective:

To evaluate the long-term results of an educational program compared to usual care.

Method:

A longitudinal study in which 56 participants from a previous study (randomized controlled clinical trial) were evaluated twelve months after the percutaneous coronary intervention (PCI). Health-related quality of life (HRQoL) was assessed by the Medical Outcomes Study: 36-item Short Form (SF-36), and anxiety and depression symptoms were assessed by the Hospital Anxiety and Depression Scale (HADS). A repeated measures analysis of variance was performed (significance level 0.05).

Results:

Participants in the educational program showed improvement of HRQoL in the Role-Emotional domain, while those in the usual care did not present changes (p=0.05). Both groups showed improvement in the Role-Physical (p = 0.001) and Bodily Pain (p=0.01) domains over time. There were no differences in the symptoms of anxiety and depression.

Conclusion:

One year after the PCI, there were significant differences between groups only for the Role-Emotional domain of the SF-36.

Descriptors:
Coronary Disease; Angioplasty; Health Education; Cardiac Rehabilitation; Telemedicine

Variable	T0 (FURUYA, 2015)⁽⁴⁾4 Furuya RK, Arantes EC, Dessotte CA, Ciol MA, Hoffman JM, Schmidt A, et al. A randomized controlled trial of an educational programme to improve self-care in Brazilian patients following percutaneous coronary intervention. J Adv Nurs[Internet]. 2015[cited 2017 Apr 11];71(4):895-908. Available from: http://onlinelibrary.wiley.com/doi/10.1111/jan.12568/epdf http://onlinelibrary.wiley.com/doi/10.11... Before PCI		p value	T1(Current study)After 12 months		p value
Variable	IG (n=29)	CG (n=27)	p value	IG (n=29)	CG (n=27)	p value
Age (in years) [M, (SD)]	63.5 (12.5)	60.2 (8.8)	0.26	64.6 (12.5)	61.3 (8.8)	0.26
Years of study [M, (SD)]	3.9 (2.9)	5.5 (4.2)	0.11	3.9 (2.9)	5.5 (4.2)	0.11
Number of dependents [M, (SD)]	3.41 (1.9)	3.1 (1.5)	0.52	2.7 (1.7)	2.7 (1.6)	0.91
Monthly family income (in Reais) [M, (SD)]	1670 (1173)	2579 (4646)	0.31	1362 (723)	1913 (1339)	0.06
Sex % (n)			0.61^* * p value from the Chi-square test (sex, marital status, performance of paid occupational activities); for the other p values, test of comparison of means (Student’s t for independent samples).			0.61^* * p value from the Chi-square test (sex, marital status, performance of paid occupational activities); for the other p values, test of comparison of means (Student’s t for independent samples).
Male	58.6 (17)	51.9 (14)		58.6 (17)	51.9 (14)	-
Female	41.4 (12)	48.1 (13)		41.4 (12)	48.1 (13)	-
Marital status % (n)			0.88^* * p value from the Chi-square test (sex, marital status, performance of paid occupational activities); for the other p values, test of comparison of means (Student’s t for independent samples).			0.87^* * p value from the Chi-square test (sex, marital status, performance of paid occupational activities); for the other p values, test of comparison of means (Student’s t for independent samples).
Married/consensual union	75.8 (22)	74.1 (20)		72.4 (21)	70.4 (19)
Single/widowed or separated	24.2 (7)	25.9 (7)		24.1 (8)	29.6 (8)
Performance of paid occupational activities % (n)			0.63^* * p value from the Chi-square test (sex, marital status, performance of paid occupational activities); for the other p values, test of comparison of means (Student’s t for independent samples).			0.17^* * p value from the Chi-square test (sex, marital status, performance of paid occupational activities); for the other p values, test of comparison of means (Student’s t for independent samples).
No	65.5 (19)	59.3 (16)		82.8 (24)	66.7 (18)
Yes	34.5 (10)	40.7 (11)		17.2 (5)	33.3 (9)

Variable	Control Group (n=27)		Intervention Group (n=29)
	^* * T0 = Initial measurement collected before the PCI (FURUYA et al., 2015); T0	^ T1 = final measurement collected 12 months after the PCI (Current study); T1	^* * T0 = Initial measurement collected before the PCI (FURUYA et al., 2015); T0	^ T1 = final measurement collected 12 months after the PCI (Current study); T1
	Mean (SD)^a (a) SD = Standard Deviation; HADS: Hospital Anxiety and Depression Scale.	Mean (SD)^a (a) SD = Standard Deviation; HADS: Hospital Anxiety and Depression Scale.	Mean (SD)^a (a) SD = Standard Deviation; HADS: Hospital Anxiety and Depression Scale.	Mean (SD)^a (a) SD = Standard Deviation; HADS: Hospital Anxiety and Depression Scale.
SF-36 domains
Social Functioning	69.9 (29.5)	72.7 (29.2)	74.6 (25.5)	74.6 (25.5)
Vitality	61.7 (24.0)	61.5 (24.9)	61.4 (23.2)	66.9 (24.5)
Mental Health	61.3 (19.9)	63.2 (13.5)	60.7 (13.7)	65.5 (14.0)
General Health	61.1 (20.5)	60.2 (21.1)	64.2 (15.0)	65.6 (21.7)
Role-Emotional	60.5 (41.4)	60.5 (43.4)	51.7 (37.3)	75.9 (35.5)
Physical Functioning	57.4 (26.7)	54.1 (31.6)	64.3 (24.1)	66.4 (24.6)
Bodily Pain	39.2 (34.3)	59.0 (27.1)	45.9 (37.5)	56.5 (28.4)
Role-Physical	32.4 (33.8)	51.8 (43.3)	29.3 (34.8)	55.2 (44.0)
HADS Subscales
Anxiety	7.3 (3.6)	6.3 (3.5)	7.0 (4.0)	6.3 (3.9)
Depression	5.5 (4.0)	5.9 (4.3)	6.5 (3.9)	5.3 (3.4)

Variable	p values by factors
Variable	Time	Group	Interaction(time x group)
SF-36 Domains
Social Functioning	0.20	0.24	0.56
Vitality	0.41	0.65	0.37
Mental Health	0.10	0.82	0.47
General Health	0.93	0.34	0.68
Role-Emotional	0.05	0.70	0.05
Physical Functioning	0.83	0.15	0.36
Bodily Pain	0.01	0.75	0.40
Role-Physical	0.001	0.99	0.61
HADS Subscales
Anxiety	0.10	0.89	0.84
Depression	0.40	0.84	0.11

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[1] CORRESPONDING AUTHOR: Lidia Aparecida Rossi. E-mail: rizzardo@eerp.usp.br