Volume 30, Issue 3 (Summer 2022)                   Avicenna J Nurs Midwifery Care 2022, 30(3): 151-162 | Back to browse issues page


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Gomar E, Karampourian A, Molavi Vardanjani M, Manafi B, Khazaei S. The effect of telephone training and follow-up on patients' adherence to the treatment regimen after myocardial infarction. Avicenna J Nurs Midwifery Care 2022; 30 (3) :151-162
URL: http://nmj.umsha.ac.ir/article-1-2354-en.html
1- Department of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
2- 2 Urology and Nephrology Research Center, Chronic Diseases (Home Care) Research Center, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran , a.karampourian@umsha.ac.ir
3- Chronic Diseases (Home Care) Research Center, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
4- Department of Surgery, School of Medicine, Farshchian Cardiovascular Subspecialty Medical Center, Hamadan University of Medical Sciences, Hamadan, Iran
5- Department of Epidemiology, Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
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Background and Objective
One of the main concerns and clinical problems presented to health system employees is patients' nonadherence to the prescribed treatment regimen. Treatment adherence assumes critical importance in chronic diseases, including patients with cardiovascular diseases who need to follow the prescribed treatment for a long time. Patient training is a basic strategy in disease control and the reduction of the complications developed by chronic diseases. It is one of the most basic responsibilities of every nurse, contributing greatly to the prevention and treatment of many diseases. Various methods are used for patient training. Considering the conflicting studies and the importance of adherence to the treatment regimen, as well as the role of education and follow-up in myocardial infarction patients, the present study aimed to compare the effect of patient education with and without telephone follow-up on the degree of adherence to treatment regimen after myocardial infarction.
Materials and Methods
This three-arm clinical trial was conducted on 150 patients with myocardial infarction admitted to the coronary care unit (CCU) of Farshchian Hospital in Hamedan. The subjects who met the inclusion criteria were randomly assigned to three groups: control, intervention 1 (face-to-face training based on training manuals), and intervention 2 (face-to-face training and telephone follow-up care), using permuted block randomization. The inclusion criteria were as follows: an elapsed time of 24 hours since patient admission, access to a landline or mobile phone and the ability to use it, the absence of a debilitating disease, no impairment in speech, hearing, and vision, reading and writing literacy, mastering the Persian language. On the other hand, the exclusion criteria entailed: unwillingness to continue participating in the research, death, relocation, accident, readmission to the hospital during the study period, and failure to answer the phone (three times).
In order to collect the data, the demographic-clinical form and the treatment adherence questionnaire were used. In intervention group 1, each patient received a one-hour face-to-face training on the importance of treatment adherence in the hospital. In intervention group 2, in addition to the mentioned training, the patients were followed up by telephone for three months. The control group received the routine car in the ward. Following that, 1.5 months after the end of the telephone follow-up and educational interventions and then three months after the end of the interventions, the treatment adherence questionnaire was completed by the patients in all three groups. Data were analyzed in SPSS statistical software (version 21).
Results
Based on the results of the repeated measures analysis of variance (ANOVA), which compared the three groups in the three stages of the study, the groups displayed a significant difference in treatment adherence in the three stages of measurement (P<0.001). The observed difference was related to the changes in treatment adherence at different stages in each group, while the groups did not significantly differ (P=0.087). The results of repeated measures ANOVA, which compared the three groups in the three stages of the study, demonstrated that the effect of group and time was significant. In other words, the groups had a significant difference in terms of the mean score of treatment adherence in the three stages of measurement (P>0.001).
Conclusion
The mean score of treatment compliance in all three groups increased by 1.5 months after the intervention; however, this increase was more pronounced in intervention group 1. The mean treatment adherence was higher in intervention group 2 in the follow-up period (i.e., three months after the intervention) compared to that in other groups. In general, during the three stages, no statistically significant difference was observed between the two methods of telephone follow-up and education alone. The results of the study pointed out that training with and without telephone follow-up did not differ in the enhancement of treatment adherence in patients with myocardial infarction compared to the control group. Both training methods (with and without telephone follow-up) led to the improvement of treatment compliance in patients with myocardial infarction. Therefore, one of them can be selected according to the conditions of hospitals and the patient's choice.
 
Type of Study: Original Research | Subject: Education in Nursing and Midwifery
Received: 2021/07/14 | Accepted: 2022/05/16 | Published: 2022/09/5

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