title: The effect of a telephone follow-up intervention on illness perception and lifestyle after myocardial infarction in China: a randomized controlled trial.
abstract: BACKGROUND
  Lifestyle modification is an integral component of cardiac secondary prevention, while it has been confirmed that myocardial infarction (MI) patients' health-related behaviors are heavily influenced by their illness perception.
  
  
  OBJECTIVE
  To evaluate the effect of a telephone follow-up intervention for improving MI patients' illness perception and lifestyle.
  
  
  METHODS
  A randomized controlled trial, longitudinal research design was employed.
  
  
  METHODS
  Cardiac care units in four major general hospitals in Guangzhou, China.
  
  
  METHODS
  Inclusion criteria were being diagnosed with an initial acute MI, being able to communicate orally in Mandarin or Cantonese and read in Chinese, and living in Guangzhou. Exclusion criteria were with continuing uncontrolled arrhythmias or heart failure, being illiteracy, or with a history of major psychiatric illness, exercise-induced asthma, uncontrolled diabetes, or evidence of dementia.
  
  
  METHODS
  124 patients admitted with the first acute MI were randomized to receive either routine care or routine care plus a telephone follow-up intervention, which consist of a pre-discharge education and three telephone follow-up instructions. Data were collected before discharge, at the 6th and the 12th week after discharge from hospital, respectively.
  
  
  RESULTS
  At the 6th and the 12th week after discharge, patients in the intervention group had significantly positive perceptions about symptoms of MI (mean difference 3.27, 95% confidence interval 2.48-4.07, p<.001; mean difference 2.12, 95% confidence interval 1.34-2.89, p<.001 respectively) and how long their illness would last (mean difference -0.69, 95% confidence interval -0.91 to -0.47, p<.001; mean difference -0.74, 95% confidence interval -0.96 to -0.51, p<.001 respectively) compared with the control group. The intervention group also had more positive beliefs about the controllability (F=4.23, p=.04) and more improved beliefs about the causes of MI than the control group. Moreover, the intervention improved the patients' nutrition (F=5.16, p=.03) and physical activity at the 12-week follow-up (mean difference 0.37, 95% confidence interval 0.17-0.58, p<.001).
  
  
  CONCLUSIONS
  This telephone follow-up intervention can result in improved illness perception and lifestyle after MI. It could be incorporated into current hospital treatment regimens for MI to improve patients' quality of life.
authors.affiliation: School of Nursing, Sun Yat-sen University, Guangzhou, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Yan
authors.affiliation: School of Nursing, Sun Yat-sen University, Guangzhou, China. Electronic address: youlm@mail.sysu.edu.cn.
authors.forename: Li-ming
authors.initials: LM
authors.lastname: You
authors.affiliation: Department of Cardiology, First Municipal People's Hospital of Guangzhou, Guangzhou, China.
authors.forename: Bai-ling
authors.initials: BL
authors.lastname: Liu
authors.affiliation: Department of Cardiology, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
authors.forename: Shang-yi
authors.initials: SY
authors.lastname: Jin
authors.affiliation: Department of Cardiology, Second Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
authors.forename: Jing-jing
authors.initials: JJ
authors.lastname: Zhou
authors.affiliation: Department of Cardiology, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
authors.forename: Chun-xi
authors.initials: CX
authors.lastname: Lin
authors.affiliation: Department of Cardiology, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
authors.forename: Qing
authors.initials: Q
authors.lastname: Li
authors.affiliation: Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Gu
mesh_terms: D000368:Aged; D002681:China; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D055809:Illness Behavior; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000503:physiopathology*; D013689:Telephone
keywords: Illness perception; Lifestyle; Myocardial infarction; Randomized controlled trial