title: Angina self-management plan and quality of life, anxiety and depression in post coronary angioplasty patients.
abstract: BACKGROUND
  Coronary artery diseases are the most frequent cause of mortality in industrialized countries as well as Iran. Coronary artery disease affects patient's quality of life (QoL) and produces some degrees of anxiety and depression. Although self-management programs have shown significant impact on chronic diseases, there is limited evidence in Iran regarding the effectiveness of these interventions, particularly in patients with coronary artery disease.
  
  
  OBJECTIVE
  This study aimed to evaluate the effects of angina plan on QoL, anxiety, and depression in post coronary angioplasty patients referred to selected hospitals in Shiraz.
  
  
  METHODS
  This parallel randomized, controlled trial was conducted in selected hospitals in Shiraz, Iran. We enrolled 80 post coronary angioplasty eligible patients in the study. After acquisition of the informed consent, eligible patients were randomly divided into two groups: control and experimental. Pretest data were obtained by using a demographic data form and two valid and reliable questionnaires for QoL, anxiety, and depression. Blood pressure, weight, and height (to calculate body mass index) were measured too. Patient's history of smoking, diabetes, hypercholesterolemia, hypertension, and coronary vascular involvement (with grade and severity) were obtained from their medical records. A 12-week angina plan intervention consisted of a 30 to 40 minutes of counseling interview and telephone follow up at the end of 1, 4, 8, and 12 weeks were performed for experimental group. Post-test data were obtained three months after the pretest using the same questionnaires as pretest. QoL data were analyzed by analysis of co-variance (ANCOVA). The results (before and after intervention) regarding anxiety and depression were analyzed by independent t-tests or their equivalent nonparametric Mann-Whitney test using SPSS v. 11.5.
  
  
  RESULTS
  There was no statistically significant difference in demographic variables between two groups. Baseline mean scores for QoL, anxiety, and depression did not differ between the two groups. There was a significant difference between the experimental and control groups in terms of changes in perception of QoL before and after the intervention. Adjusted mean ± SD of perception of QoL for the control group was 38.48 ± 13.38 and for the experimental one was 56.30 ± 13.38, with a P value of less than 0.001. The mean difference of anxiety scores (before and after intervention) in experimental and control groups were 1.15 ± 1.99 and-.0.07 ± 2.22, respectively with a P value of less than 0.01. The mean difference of depression scores (before and after intervention) in experimental and control groups were 0.4 ± 2.89 and 0.13 ± 2.76, respectively (P > 0.05).
  
  
  CONCLUSIONS
  Our results show that the self-management angina plan was effective in improving perception of QoL and reducing anxiety. Further studies with a larger sample size and a longer follow-up period are recommended to better understand the effectiveness of this plan.
authors.affiliation: Department of Nursing, Faculty of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, IR Iran.
authors.forename: Marzieh
authors.initials: M
authors.lastname: Moattari
authors.affiliation: Department of Nursing, Faculty of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, IR Iran.
authors.forename: Fakhteh
authors.initials: F
authors.lastname: Adib
authors.affiliation: Department of Cardiology, Faculty of Medicine, Shiraz University of Medical Sciences, Shiraz, IR Iran.
authors.forename: Javad
authors.initials: J
authors.lastname: Kojuri
authors.affiliation: Department of Statistics, Faculty of Health, Shiraz University of Medical Sciences, Shiraz, IR Iran.
authors.forename: Seyed Hamid Reza
authors.initials: SH
authors.lastname: Tabatabaee
keywords: Cardiovascular Disease; Iran; Patient Education; Self-Care