title: Motivation is a crucial factor for adherence to a healthy lifestyle among people with coronary heart disease after percutaneous coronary intervention.
abstract: OBJECTIVE
  To test the Theory of Adherence of People with Chronic Disease with regard to adherence to treatment among patients with coronary heart disease after a percutaneous coronary intervention.
  
  
  BACKGROUND
  Increased knowledge of the concept of adherence is needed for the development of nursing interventions and nursing guidelines for patients with coronary heart disease.
  
  
  METHODS
  A cross-sectional, multi-centre study.
  
  
  METHODS
  This study was conducted from February-December 2013 with 416 patients with coronary heart disease 4 months after undergoing a percutaneous coronary intervention. A self-reported questionnaire was used to assess their adherence to treatment. Data were analysed using structural equation modelling.
  
  
  RESULTS
  The theory explained 45% of the adherence to a healthy lifestyle and 7% of the adherence to medication. Structural equation modelling confirmed that motivation and results of care had the highest association with adherence to a healthy lifestyle. Responsibility was associated with adherence to medication. Support from next of kin, support from nurses and physicians, and motivation, co-operation, fear of complications and a sense of normality were associated with adherence.
  
  
  CONCLUSIONS
  Patients who are motivated to perform self-care and consider the results of care to be important were more likely to adhere to a healthy lifestyle. Responsible patients were more likely to adhere to their medication. It is important to account for these elements as a part of secondary prevention strategies among patients with coronary heart disease after a percutaneous coronary intervention.
authors.affiliation: Department of Nursing Science, University of Eastern Finland, Kuopio, Finland.
authors.forename: Outi
authors.initials: O
authors.lastname: Kähkönen
authors.affiliation: Department of Nursing Science, University of Eastern Finland, Kuopio, Finland.
authors.forename: Päivi
authors.initials: P
authors.lastname: Kankkunen
authors.affiliation: Department of Nursing Science, University of Eastern Finland, Kuopio, Finland.
authors.forename: Terhi
authors.initials: T
authors.lastname: Saaranen
authors.affiliation: Kuopio University Hospital, Finland.
authors.forename: Heikki
authors.initials: H
authors.lastname: Miettinen
authors.affiliation: Department of Health Science, University of Oulu, Finland.
authors.forename: Helvi
authors.initials: H
authors.lastname: Kyngäs
authors.affiliation: Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland.
authors.forename: Marja-Leena
authors.initials: ML
authors.lastname: Lamidi
mesh_terms: D003327:Coronary Disease / Q000523:psychology* / Q000601:surgery; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D009204:Myocardial Revascularization / Q000379:methods / Q000523:psychology; D010349:Patient Compliance; D062645:Percutaneous Coronary Intervention / Q000523:psychology*; D040242:Risk Reduction Behavior
keywords: adherence level to treatment; coronary heart disease; nursing; nursing theory; percutaneous coronary intervention; structural equation modelling