title: Person-centred care improves self-efficacy to control symptoms after acute coronary syndrome: a randomized controlled trial.
abstract: BACKGROUND
  Person-centred care (PCC) aims to engage patients as active partners in their care and treatment to improve the management of their illness. Self-efficacy is an important concept and outcome in PCC as it refers to a patient's belief in their capability to manage the events that affect their lives. Recovery after acute coronary syndrome (ACS) is demanding and a PCC approach may promote self-efficacy and thereby facilitate recovery.
  
  
  OBJECTIVE
  The purpose of this study was to evaluate whether a PCC intervention was able to improve self-efficacy after hospitalization for ACS.
  
  
  METHODS
  In a randomized controlled trial, patients <75 years of age and hospitalized for ACS were assigned to either a usual care group or a PCC intervention group. Self-efficacy was assessed at baseline and up to six months after discharge using the Swedish Cardiac Self-Efficacy Scale (S-CSES), which consists of three dimensions: control symptoms, control illness and maintain functioning.
  
  
  RESULTS
  In total, 177 patients were included in the study: 93 in the usual care group and 84 in the PCC group. At the one-month follow-up the PCC group had improved significantly more (p=0.049) on the control symptoms dimension (mean change 0.81; SD 3.5 versus mean change -0.20; SD 3.0). No difference between groups was seen at the six-month follow-up in any of the S-CSES dimensions.
  
  
  CONCLUSIONS
  Our results indicate that PCC added to usual care promotes and hastens the development of patients' confidence in their ability to manage symptoms during recovery after ACS. This underlines the importance of initiating and establishing partnerships between patients and health care professionals as early as possible after ACS.
authors.affiliation: Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden Centre for Person-Centred Care, University of Gothenburg, Sweden Närhälsan Research and Development, Primary Health Care, Region Västra Götaland, Sweden andreas.fors@gu.se.
authors.forename: Andreas
authors.initials: A
authors.lastname: Fors
authors.affiliation: Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden Centre for Person-Centred Care, University of Gothenburg, Sweden.
authors.forename: Charles
authors.initials: C
authors.lastname: Taft
authors.affiliation: Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden Centre for Person-Centred Care, University of Gothenburg, Sweden.
authors.forename: Kerstin
authors.initials: K
authors.lastname: Ulin
authors.affiliation: Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden Centre for Person-Centred Care, University of Gothenburg, Sweden.
authors.forename: Inger
authors.initials: I
authors.lastname: Ekman
mesh_terms: D054058:Acute Coronary Syndrome / Q000523:psychology* / Q000628:therapy*; D000368:Aged; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D018802:Patient-Centered Care; D020127:Recovery of Function; D020377:Self Efficacy; D013548:Sweden; D016896:Treatment Outcome
keywords: acute coronary syndrome; cardiac rehabilitation; patient-centered care; person-centred care; randomized controlled trial; self-efficacy