Volume 30, Issue 2 (Spring 2022)                   Avicenna J Nurs Midwifery Care 2022, 30(2): 98-106 | Back to browse issues page

Ethics code: IR.UMSHA.REC.1399.409

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Khodaveisi M, salmani ghabeshi M, Amini R, Tapak L. The Effect of Post-discharge Telephone Training and Follow-up on Self-care Behaviors of Myocardial Infarction Patients. Avicenna J Nurs Midwifery Care 2022; 30 (2) :98-106
URL: http://nmj.umsha.ac.ir/article-1-2332-en.html
1- Department of Comunity Health Nursing, Chronic Diseases (Home Care) Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
2- Hamadan University of Medical Sciences, Hamadan, Iran , mehranghabeshi@gmail.com
3- Chronic Diseases (Home Care) Research Center, Department of Community Health Nursing, Faculty of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
4- Department of Biostatistic, Faculty of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
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Background and Objective
Myocardial infarction is one of the most debilitating diseases widespread across the globe. Although many of these patients survive owing to dramatic advances in treatment methods, improving the quality and quantity of life among these patients is entirely reliant on care, especially post-discharge care. The majority of these patients are discharged from the hospital in good general condition and receive medical advice regarding medication, proper, nutrition, and daily physical activity; nonetheless, most of them are rehospitalized with acute symptoms. Poor self-care has been recognized as one of the most common reasons for readmission that imposes a huge cost on the patient and the healthcare system.
Despite the recommendations of health care providers, we are witnessing poor self-care behaviors, such as adherence to medication, diet, and physical activity among patients with myocardial infarction, especially in developing countries. In this regard, training on self-care behaviors can reduce the recurrence of symptoms and hospitalization of these patients. In light of the aforementioned issues, the present study aimed to assess the effect of post-discharge education and follow-up on self-care behaviors of myocardial infarction patients in Iran.
Materials and Methods
The present study was conducted based on a quasi-experimental control group design. A total of 116 patients who met the inclusion criteria were selected via the convenience sampling method and assigned to two groups by block randomization method. At the commencement of the study, in the first visit, a self-care questionnaire was completed by patients in both groups. on the day of discharge, patients in the intervention group attended a face-to-face training session and received pamphlets and training CDs containing information on the signs and symptoms of the need to revisit, following medication instructions and diets, levels of authorized physical activity, risk factors for the recurrence of stroke, the effects of stress, adjustment of the effect of tension, and unauthorized care; moreover, all their questions were answered.
The duration of the training session varied from half an hour to one hour according to the needs of the patients and their questions. Thereafter, telephone follow-up (landline or mobile phone), along with training in the intervention group, continued for eight weeks. Immediately after discharge, the participants in the intervention group were contacted via phone twice a week in the first month and once a week in the second month. Furthermore, the necessary training was performed in accordance with the self-care training booklet for patients with myocardial infarction. In total, each subject was contacted 12 times during the eight-week intervention. The duration of each call was between 10-15 min according to the patient's questions. Patients in the control group only received the routine care and training provided in cardiology hospitals. To measure self-care, the Miller Self-Care Behavior Scale was completed before and after the intervention. Data were analyzed in SPSS software (version 23).
The mean age scores of patients in the intervention and control groups were 61.79±7.58 and 58.65±9.97, respectively. In terms of gender, the majority of patients in the two groups of control (65.5%) and intervention (67.2%) were males. Moreover, all patients in both control and intervention groups were married. Based on the statistical tests performed, the two groups did not differ in demographic characteristics. Repeated measures analysis. Greenhouse-Geisser pointed to a significant increase in the mean score of self-care in the intervention group (P<0.001).
Moreover, the mean score of self-care was higher in the intervention group, as compared to that in the control group, upon discharge, as well as one and two months after training. The use of an independent t-test did not demonstrate a statistically significant difference between the two groups in terms of self-care scores upon discharge (P=0.778). Nevertheless, the two groups did not differ significantly in the mean score of self-care one and two months after training (P<0.001).
As evidenced by the obtained results, telephone training and follow-up improved self-care behaviors and some of its dimensions in the intervention group, compared to those in the control group. That is to say, telephone training and follow-up turned out to be effective in this study. It seems that learning self-care behaviors can lead a person to maintain health and well-being; moreover, it enhances people’s adaptation to diseases and their ability to take care of themselves. Post-discharge telephone follow-up can be of great help helpful in the identifying and breaching the care gaps that may occur after discharge from the hospital.
Consistent with the results of the present study, Cavradim et al. (2020) reported that in the 12th week after discharge, patients in the intervention group had higher levels of self-care, quality of life, and adaptation, compared to the control group, and these differences were statistically significant. In the stated study, the telephone follow-up method was used for patients in the intervention group. Moreover, despite the difference between the referred research and the present study in the intervention content and the length of follow-up, relatively similar results were obtained, highlighting the importance of post-discharge follow-up in patients with cardiovascular diseases.
As evidenced by the results of this study, telephone training and follow-up in patients with myocardial infarction improved their self-care behaviors. It seems that the cheapness, availability, and ease of use of this method have made it an effective and appropriate way to follow the training provided to patients. Due to the effect of telephone education on the enhancement of patients' self-care behaviors, it is recommended that training workshops on the use of new educational methods, such as telephone follow-up, be held for nurses in educational and medical centers.
Type of Study: Original Research | Subject: Nursing
Received: 2021/05/12 | Accepted: 2022/02/27 | Published: 2022/05/31

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