Effectiveness of nurse‐led counselling and education on self‐efficacy of patients with acute coronary syndrome: A randomized controlled trial

Q: What are the key findings of this study?

Nurse-led person-centred counselling and education improved total cardiac self-efficacy scores at 1 month compared to routine care.

Q: What is the clinical evidence from this study?

Study design: RCT. Population: Acute coronary syndrome (ACS) with poor baseline cardiac self-efficacy (n=120). Intervention: Nurse-led counselling and education programme using a person-centred care (PCC) approach vs. Routine care (verbal discharge education and information pamphlet). Primary outcome: Total cardiac self-efficacy score at 1 month after discharge (p=<0.001).

Q: What does this research mean for the field?

Nurse-led person-centred counselling and education significantly improves short-term cardiac self-efficacy, including symptom control and function maintenance, in patients with acute coronary syndrome. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.NEUTRAL.

Q: What question did this study set out to answer?

To evaluate the effect of a nurse-led counselling and education programme using a person-centred care approach on short-term cardiac self-efficacy in patients hospitalized with acute coronary syndrome.

Hossein Bagheri; Sara Shakeri; Ali‐Mohammad Nazari; Shahrbanoo Goli; Mahboobeh Khajeh; Abbas Mardani; Željko Vlaisavljević

doi:10.1002/nop2.1129

November 12, 2021Nursing OpenOpen Access

Effectiveness of nurse‐led counselling and education on self‐efficacy of patients with acute coronary syndrome: A randomized controlled trial

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Key result

Nurse-led person-centred counselling boosts 1-month cardiac self-efficacy by ~8 points over routine care.

P<0.001
n=120

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Why the study?

Adherence to lifestyle recommendations, medical regimens, and cardiac rehabilitation is poor among patients with acute coronary syndrome.

Does a nurse-led counselling and education programme using a person-centred care approach improve short-term cardiac self-efficacy at 1 month post-discharge in patients hospitalized with acute coronary syndrome?

Key Points

To evaluate the effect of a nurse-led counselling and education programme using a person-centred care approach on short-term cardiac self-efficacy in patients hospitalized with acute coronary syndrome.
A parallel, two-armed randomized controlled trial enrolled 120 hospitalized patients with acute coronary syndrome, randomly assigned to an intervention group (n = 60) or a control group (n = 60).
The intervention group received routine care plus two face-to-face sessions and two telephone sessions focused on person-centred counselling and education, while controls received routine care alone.
Outcomes were assessed before the intervention and 1 month after discharge using the cardiac self-efficacy scale, evaluating symptom control and functional maintenance dimensions.
At 1 month after discharge, total cardiac self-efficacy was significantly higher in the intervention group than in the control group (mean 32.23 [SD 4.91] vs 23.93 [SD 6.66]; p < .001).
Scores for the control symptoms dimension were significantly improved in the intervention group compared with controls at 1 month post-discharge (mean 19.40 [SD 3.19] vs 13.73 [SD 4.45]; p < .001).
Scores for maintaining function at 1 month post-discharge were significantly higher with the intervention compared with control care (mean 12.83 [SD 2.40] vs 10.20 [SD 2.88]; p < .001).

Study Design

Type

RCT (n=120)

Blinding

Single-blind (participants and data collector were not blinded; only the data analyser was blinded)

Randomization

Block randomization (block size of 4, 30 blocks) with sequentially numbered sealed opaque envelopes

Multicenter

No

Structured PICO

Does a nurse-led counselling and education programme using a person-centred care approach improve short-term cardiac self-efficacy at 1 month post-discharge in patients hospitalized with acute coronary syndrome?

P

Population

120 patients under age 75 hospitalized with acute coronary syndrome and poor baseline cardiac self-efficacy at a single center in Iran, followed for 1 month post-discharge.

I

Intervention

Nurse-led counselling and education programme using a person-centred care (PCC) approach added to routine care, consisting of Phase I (20-30 min face-to-face session and booklet 1 day prior to discharge), Phase II (written tailored care plan on day of discharge), and Phase III (two 10-minute telephone counselling and follow-up sessions at 1 and 3 weeks post-discharge).

C

Comparator

Routine care alone, consisting of verbal discharge education and an information pamphlet provided by nursing staff about diet, medications, cardiac symptoms, and individual risk factors.

O

Outcome

Total cardiac self-efficacy (and its dimensions: control symptoms and maintain functioning) measured by the 13-item Sullivan Cardiac Self-Efficacy Scale (score range 0-52) at 1 month after hospital discharge.patient reported

Main Result

Absolute Event Rate: 32.23% vs 23.93%

p-value: p=<0.001

A structured, nurse-led person-centred counselling and education programme combining inpatient sessions with post-discharge telephone follow-up significantly improves 1-month cardiac self-efficacy in patients recovering from acute coronary syndrome.

Limitations

Single academic hospital setting and age restriction (<75 years) limit generalizability
Short-term follow-up limited to 1 month post-discharge
Post-intervention evaluation was performed only one week after the second telephone counselling session
Counselling, education, and data collection were performed by the same unblinded researcher
Outcomes relied on a self-report scale without physiological parameters or hard clinical outcomes (e.g., readmission, mortality)
Participants were <75 years old and recruited from a single academic hospital, limiting generalizability
Only short-term self-efficacy (up to 1 month post-discharge) was measured
Post-intervention evaluation was conducted only 1 week after the final telephone session
Intervention delivery and data collection were performed by the same researcher, introducing potential bias
Relied solely on self-reported scale without assessing physiological parameters or clinical outcomes such as readmission or mortality

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Implication

Supports routine integration into ACS discharge care; extends RCT evidence for person-centred nurse interventions on self-efficacy.

Abstract

AIM: Adherence to lifestyle recommendations, medical regimens and cardiac rehabilitation is poor among patients with acute coronary syndrome. The aim of this study was to examine the effect of nurse-led counselling and education using a person-centred care approach on short-term cardiac self-efficacy in patients with acute coronary syndrome. DESIGN: A parallel, two-armed, randomized controlled trial was conducted. METHODS: One hundred twenty patients who were hospitalized with diagnosis of acute coronary syndrome were selected and randomly assigned into intervention (n = 60) or control (n = 60) groups. In the intervention group, in addition to routine care, the nurse-led counselling and education programme included two face-to-face sessions, two telephone counselling and education sessions, using the person-centred care approach. Participants in the control group received only routine care. Data were collected using the cardiac self-efficacy scale before the intervention and 1 month after discharge. RESULTS: After the intervention, we found that cardiac self-efficacy, including the perceived self-efficacy to control symptoms and maintain function, was statistically significantly higher in the intervention group than the control group.

Discussion

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Cite This Study

Bagheri et al. (2021) conducted an RCT in Acute coronary syndrome (ACS) with poor baseline cardiac self-efficacy (n=120). Nurse-led counselling and education programme using a person-centred care (PCC) approach vs. Routine care (verbal discharge education and information pamphlet) was evaluated on Total cardiac self-efficacy score at 1 month after discharge (p=<0.001). Nurse-led person-centred counselling and education improved total cardiac self-efficacy scores at 1 month compared to routine care.

synapsesocial.com/papers/6a7734c3a7498e5110ae623c https://doi.org/10.1002/nop2.1129

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Effectiveness of nurse‐led counselling and education on self‐efficacy of patients with acute coronary syndrome: A randomized controlled trial

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Effectiveness of nurse‐led counselling and education on self‐efficacy of patients with acute coronary syndrome: A randomized controlled trial

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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