Contribution of nursing to risk factor management as perceived by patients with established coronary heart disease.
BACKGROUND
Guidelines stress the importance of risk factor management in patients with coronary heart disease (CHD).


OBJECTIVE
To evaluate whether guidelines on patient education in risk factor management are followed in clinical practice and to assess the contribution of nursing to risk factor management as perceived by patients with established CHD.


METHODS
Within three Dutch hospitals consecutive patients were identified after a first coronary-artery bypass graft, a first percutaneous transluminal coronary angioplasty or hospital admission for acute myocardial infarction or ischaemia (n=357). Data were collected through patient interviews at least 6 months after hospital admission.


RESULTS
Among smokers, overweight patients, patients with hypertension, high cholesterol, and sedentary lifestyle, respectively 75, 36, 67, 61 and 49% reported that information on presence or management of these risk factors was provided. The proportion of patients informed by nurses ranged from 14% (lowering cholesterol) to 23% (increasing physical activity), while 55% (lowering cholesterol) to 71% (stop smoking) were informed by physicians.


CONCLUSIONS
Many patients with established CHD and cardiovascular risk factors do not remember ever having received information about management of their risk factors. Clearly, there is a substantial potential to improve professionals' compliance to guidelines on risk factor management, including those on patient education. The perceived contribution of nurses to risk factor management is small compared to that of physicians and other caregivers. If risk factor management is felt to be a main responsibility of nurses, current nursing activities in this area should be reconsidered within an improved organisational structure.
Scholte op Reimer
Wilma J M
WJ
Department of Cardiology/Clinical Epidemiology, Erasmus Medical Center Rotterdam, Dijkzigt Hospital, Room H556, Dr Molewaterplein 40, 3015 GD Rotterdam, The Netherlands. scholteopreimer@thch.azr.nl
Jansen
Chris H
CH
de Swart
Esther A M
EA
Boersma
Eric
E
Simoons
Maarten L
ML
Deckers
Jaap W
JW
D003327:Coronary Disease / Q000209:etiology* / Q000451:nursing / Q000517:prevention & control; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000150:complications*; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D024802:Nurse's Role; D009765:Obesity / Q000150:complications*; D010353:Patient Education as Topic; D017410:Practice Guidelines as Topic; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects*