title: 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.
abstract: 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.
authors.affiliation: 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
authors.forename: Sharon
authors.initials: S
authors.lastname: McKinley
authors.forename: Kathleen
authors.initials: K
authors.lastname: Dracup
authors.forename: Debra K
authors.initials: DK
authors.lastname: Moser
authors.forename: Barbara
authors.initials: B
authors.lastname: Riegel
authors.forename: Lynn V
authors.initials: LV
authors.lastname: Doering
authors.forename: Hendrika
authors.initials: H
authors.lastname: Meischke
authors.forename: Leanne M
authors.initials: LM
authors.lastname: Aitken
authors.forename: Tom
authors.initials: T
authors.lastname: Buckley
authors.forename: Andrea
authors.initials: A
authors.lastname: Marshall
authors.forename: Michele
authors.initials: M
authors.lastname: Pelter
mesh_terms: 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