Randomized controlled trial of tailored nursing interventions to improve cardiac rehabilitation enrollment

Nurs Res. Mar-Apr 2012;61(2):111-20. doi: 10.1097/NNR.0b013e318240dc6b.

Abstract

Background: Short hospital stays for patients with acute coronary syndromes (ACSs) reduce the opportunity for risk factor intervention during admission. After discharge, cardiac rehabilitation can decrease the recurrence of coronary events by up to 25%. However, it remains underused.

Objectives: The aim of this study was to determine whether a nursing intervention focused on individual ACS patients' perceptions of their disease and treatment would increase rehabilitation enrollment after discharge.

Method: A total of 242 ACS patients admitted to a specialized tertiary cardiac center were randomized to either the intervention or usual care (n = 121 in both groups). The intervention included one nurse-patient meeting before discharge with 2 additional contacts over the 10 days after discharge (mean duration = 40 minutes per contact). The primary outcome was enrollment in a free rehabilitation program offered to all participants 6 weeks after discharge. Secondary outcomes included illness perceptions; family support; anxiety level; medication adherence; and cardiac risk factors including lack of exercise, smoking, body mass index, and diet.

Results: The sample was composed of a majority of male, married workers who experienced a myocardial infarction or unstable angina without severe complications. The mean hospital stay in both groups was 3.6 days. There was a significantly higher rate of rehabilitation enrollment in the intervention group (45%) than in the control group (24%; p = .001). For the secondary outcomes, only the personal control dimension of illness perceptions was improved significantly with the intervention.

Discussion: Progressive, individualized interventions by nurses resulted in greater rehabilitation enrollment, thereby potentially improving long-term outcome.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Coronary Syndrome / nursing*
  • Acute Coronary Syndrome / rehabilitation*
  • Aftercare / organization & administration
  • Aged
  • Continuity of Patient Care / organization & administration
  • Female
  • Humans
  • Male
  • Middle Aged
  • Nurse's Role*
  • Nurse-Patient Relations*
  • Nursing Evaluation Research
  • Patient Acceptance of Health Care / psychology
  • Patient Compliance / psychology*
  • Patient Education as Topic / organization & administration
  • Precision Medicine / methods*
  • Treatment Outcome