The effect of a short one-on-one nursing intervention on knowledge, attitudes and beliefs related to response to acute coronary syndrome in people with coronary heart disease: a randomized controlled trial.
BACKGROUND
Coronary heart disease (CHD) and acute coronary syndrome (ACS) remain significant public health problems. The effect of ACS on mortality and morbidity is largely dependent on the time from symptom onset to the time of reperfusion, but patient delay in presenting for treatment is the main reason timely reperfusion is not received.


OBJECTIVE
We tested the effect of an education and counseling intervention on knowledge, attitudes and beliefs about ACS symptoms and the appropriate response to symptoms, and identified patient characteristics associated with changes in knowledge, attitudes and beliefs over time.


METHODS
We conducted a two-group randomized controlled trial in 3522 people with CHD. The intervention group received a 40 min, one-on-one education and counseling session. The control group received usual care. Knowledge, attitudes and beliefs were measured at baseline, 3 and 12 months using the ACS Response Index and analyzed with repeated measures analysis of variance.


RESULTS
Knowledge, attitudes and beliefs scores increased significantly from baseline in the intervention group compared to the control group at 3 months, and these differences were sustained at 12 months (p=.0005 for all). Higher perceived control over cardiac illness was associated with more positive attitudes (p<.0005) and higher state anxiety was associated with lower levels of knowledge (p<.05), attitudes (p<.05) and beliefs (p<.0005).


CONCLUSIONS
A relatively short education and counseling intervention increased knowledge, attitudes and beliefs about ACS and response to ACS symptoms in individuals with CHD. Higher perceived control over cardiac illness was associated with more positive attitudes and higher state anxiety was associated with lower levels of knowledge, attitudes and beliefs about responding to the health threat of possible ACS.
McKinley
Sharon
S
University of Technology Sydney and Northern Sydney Central Coast Health, Critical Care Nursing Professorial Unit, Level 6, Royal North Shore Hospital, St Leonards, NSW 2065, Australia. sharon.mckinley@uts.edu.au
Dracup
Kathleen
K
Moser
Debra K
DK
Riegel
Barbara
B
Doering
Lynn V
LV
Meischke
Hendrika
H
Aitken
Leanne M
LM
Buckley
Tom
T
Marshall
Andrea
A
Pelter
Michele
M
D054058:Acute Coronary Syndrome / Q000451:nursing* / Q000523:psychology; D000368:Aged; D000369:Aged, 80 and over; D003327:Coronary Disease / Q000451:nursing* / Q000523:psychology; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods / Q000592:standards*; D015397:Program Evaluation