Transforming Knowledge into Self-Care: An Educational Approach for Coronary Heart Disease Patients

Background: Coronary heart disease (CHD) remains a leading cause of global cardiovascular mortality, requiring comprehensive self-care management. Structured educational interventions show promise, but robust methodological evaluation using baseline-adjusted models is necessary to establish efficacy. Objective: To evaluate the effect of a structured educational intervention on knowledge, attitudes, and self-care management behaviors among CHD patients. Method: A non-randomized quasi-experimental pretest–posttest study was conducted with 156 outpatient CHD patients assigned to an intervention group (n = 78; receiving a 4-week structured nurse-led educational program) or a control group (n = 78; receiving usual care). Sample size was determined a priori using GPower (f = 0.25, α= 0.05, power = 0.80). Outcomes were assessed at baseline and immediately post-intervention using validated questionnaires (Cronbach’s α= 0.79–0.84). Primary analysis utilized Analysis of Covariance (ANCOVA) adjusted for baseline pretest scores and potential confounders, alongside Bonferroni-Holm adjustments and multivariable linear regression. Results: Baseline scores were comparable between groups (p > 0.50). Post-intervention, baseline-adjusted ANCOVA revealed significantly higher scores in the intervention group compared to controls across all outcomes: Knowledge (adjusted mean difference 23.03; F(1,152) = 382.4, p < 0.001, ∂h2 = 0.71; dppc = 1.42), Attitude (adjusted mean difference 21.19; F(1,152) = 412.1, p < 0.001, ∂h2 = 0.73; dppc = 1.38), and Total Self-Care Management (adjusted mean difference 24.40; F(1,152) = 345.8, p < 0.001, ∂h2 = 0.69; dppc = 1.29). Multivariable linear regression indicated that intervention assignment demonstrated the strongest standardized association with self-care improvements (β= 0.764, p < 0.001), followed by education level (β = 0.152, p < 0.001) and prior healthcare information sources (β = 0.098, p = 0.017). Conclusion: A structured educational intervention significantly improves short-term knowledge, attitudes, and self-care management in outpatient CHD patients. Integrating structured nurse-led education into routine outpatient cardiac rehabilitation is recommended, while considering individual educational levels and illness duration.