Effects of Educational Intervention on Lifestyle Among Iranian Patients After Coronary Angioplasty: A Randomized Controlled Trial

Document Type: Original Article

Authors

1 Department of Community health nursing t, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.

2 Department of Community Health Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.

3 Department of Biostatistics, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Science, Tehran, IR Iran.

Abstract

Background: Cardiovascular disease risk factors are associated with lifestyle, and patients undergoing coronary angioplasty require a great deal of training on modifying their lifestyle. The aim of this study was to survey the effects of educational intervention on lifestyle among Iranian patients after coronary angioplasty in Tehran in 2017.
Methods: This research was a randomized clinical trial with 2 groups of control (n = 29) and intervention (n = 28). The patients’ lifestyle was evaluated by using a healthy lifestyle questionnaire at baseline and then at 1 month and 3 months after an educational intervention. The data were analyzed using SPSS, version 20.
Results: The mean age of the intervention and control groups was 62.54 ± 4.23 and 60.52 ± 5.37 years old, respectively. The Mann–Whitney U and Friedman tests showed that the scores of healthy lifestyle, healthy nutrition, and exercise and physical activity significantly improved in the intervention group in comparison with the control group at 1 month and 3 months after the educational program (P < 0.001). The Friedman test showed a significant increase in the score of avoiding tobacco and alcoholic beverages, health responsibility, health-based purchase, and healthy lifestyle in both groups at 1 month and 3 months after the educational program (P < 0.05). The results revealed that the score of stress management in both groups did not increase significantly during the survey.
Conclusions: In the present study, our educational program had a considerable effect on modifying lifestyle among the Iranian patients after coronary angioplasty. Psychological support programs for managing the stress of these patients are suggested. 

Keywords


1. WHO. Health topics. Cardiovascular diseases
(CVDs) 2019. Available from:
https://www.who.int/cardiovascular_diseases/gl
obal-hearts/Global_hearts_initiative/en/
2. WHO E. Health topics. Cardiovascular diseases
2019. Available from:
http://www.emro.who.int/healthtopics/cardiovascular-diseases/index.html
3. Maddahi M-E, Nikpajouh A, Khalatbari J,
Zakerini SM, Hashemi S. Effects of metacognitive training and mindfulness-based
cognitive therapy on couple communication
patterns with the mediation of perceived stress,
perceived social support, and emotion regulation
in patients with coronary heart disease. Iranian
Heart Journal. 2018;19(1):6-14.
4. Estebsari F, Dastoorpoor M, Mostafaei D,
Khanjani N, Khalifehkandi ZR, Foroushani AR,
et al. Design and implementation of an
empowerment model to prevent elder abuse: a
randomized controlled trial. Clinical
interventions in aging. 2018;13:669.
5. Ahmadi A, Mobasheri M, Soori H. Prevalence
of major coronary heart disease risk factors in
Iran. International Journal of Epidemiologic
Research. 2014;1(1).
6. Sharif F, Moshkelgosha F, Molazem Z, Kalyani
MN, Vossughi M. The effects of discharge plan
on stress, anxiety and depression in patients
undergoing percutaneous transluminal coronary
angioplasty: a randomized controlled trial.
International journal of community based
nursing and midwifery. 2014;2(2):60.
7. Barbaresko J, Rienks J, Nöthlings U. Lifestyle
Indices and Cardiovascular Disease Risk: A
Meta-analysis. American journal of preventive
medicine. 2018;55(4):555-64.
8. Jørstad HT, Minneboo M, Helmes HJ, Fagel
ND, op Reimer WJS, Tijssen JG, et al. Effects
of a nurse-coordinated prevention programme
on health-related quality of life and depression
in patients with an acute coronary syndrome:
results from the RESPONSE randomised
controlled trial. BMC cardiovascular disorders.
2016;16(1):144.
9. Dobber J, Latour C, Snaterse M, van Meijel B,
ter Riet G, Scholte op Reimer W, et al.
Developing nurses’ skills in motivational
interviewing to promote a healthy lifestyle in
patients with coronary artery disease. European
Journal of Cardiovascular Nursing.
2018:1474515118784102.
10. Tailakh A, Mentes JC, Morisky DE, Pike NA,
Phillips LR, Evangelista LS. Prevalence,
awareness, treatment, and control of
hypertension among Arab Americans. The
Journal of cardiovascular nursing.
2013;28(4):330.
11. Hayman LL, Berra K, Fletcher BJ, Miller NH.
The role of nurses in promoting cardiovascular
health worldwide: the global cardiovascular
nursing leadership forum. Journal of the
American College of Cardiology.
2015;66(7):864-6.
12. Ghaffari S, Hakim H, Pourafkari L, Asl ES,
Goldust M. Twenty-year route of prevalence of
risk factors, treatment patterns, complications,
and mortality rate of acute myocardial infarction
in Iran. Therapeutic advances in cardiovascular
disease. 2013;7(3):117-22.
13. Ornish D, Scherwitz LW, Billings JH, Gould
KL, Merritt TA, Sparler S, et al. Intensive
lifestyle changes for reversal of coronary heart
disease. Jama. 1998;280(23):2001-7.
14. Diggle P, Diggle PJ, Heagerty P, Heagerty PJ,
Liang K-Y, Zeger S. Analysis of longitudinal
data: Oxford University Press. 2002:28-29.
15. Maleki A, Haghjoo M, Ghaderi M. The impact
of gender differences on healthy lifestyle and its
subscales among patients with coronary artery
disease. Research in Cardiovascular Medicine.
2016;5(4):6.
16. Foroushani AR, Estebsari F, Mostafaei D,
Ardebili HE, Shojaeizadeh D, Dastoorpour M,
et al. The effect of health promoting intervention
on healthy lifestyle and social support in elders:
a clinical trial study. Iranian Red Crescent
Medical Journal. 2014;16(8).
17. Majabadi HA, Solhi M, Montazeri A,
Shojaeizadeh D, Nejat S, Farahani FK, et al.
Factors influencing fast-food consumption
among adolescents in tehran: a qualitative study.
Iranian Red Crescent Medical Journal.
2016;18(3).
18. Eshah NF, Bond AE, Froelicher ES. The effects
of a cardiovascular disease prevention program
on knowledge and adoption of a heart healthy
lifestyle in Jordanian working adults. European
Journal of Cardiovascular Nursing.
2010;9(4):244-53.

19. Irmak Z, Fesci H. Effects of nurse-managed
secondary prevention program on lifestyle and
risk factors of patients who had experienced
myocardial infarction. Applied Nursing
Research. 2010;23(3):147-52.
20. Yavarikia M, Shahamfar J, Amidfar H.
Assessment of the Role of Education in
Changing Lifestyle in Patients with Coronary
Heart Diseases. Journal of cardiovascular and
thoracic research. 2011;3(2):63.
21. Winzer EB, Woitek F, Linke A. Physical
activity in the prevention and treatment of
coronary artery disease. Journal of the American
Heart Association. 2018;7(4):e007725.
22. Redfern J, Briffa T, Ellis E, Freedman SB.
Choice of secondary prevention improves risk
factors after acute coronary syndrome: 1-year
follow-up of the CHOICE (Choice of Health
Options In prevention of Cardiovascular Events)
randomised controlled trial. Heart.
2009;95(6):468-75.
23. Ko Y, Boo S. Selfperceived health versus
actual cardiovascular disease risks. Japan
Journal of Nursing Science. 2016;13(1):65-74.
24. Antoniou K, Dokoutsidou H. QUALITY OF
LIFE AFTER CORONARY INTERVENTION.
Health Science Journal. 2009;3(2).
25. Perk J, De Backer G, Gohlke H, Graham I,
Reiner E, Verschuren M, et al.
[InlineMediaObject not available: see fulltext.]
European Guidelines on Cardiovascular Disease
Prevention in Clinical Practice (Version 2012).
International Journal of Behavioral Medicine.
2012;19(4):403.
26. Farquhar JM, Stonerock GL, Blumenthal JA.
Treatment of Anxiety in Patients with Coronary
Heart Disease: A Systematic Review.
Psychosomatics. 2018;59(4):318-32.
27. Dehdari T, Heidarnia A, Ramezankhani A,
Sadeghian S, Ghofranipour F. Anxiety, self
efficacy expectation and social support in
patients after coronary angioplasty and coronary
bypass. Iranian journal of public health.
2008;37(4):119-25.
28. Rezapour P, Shahriari M, Moieni M, Sanei H.
Investigating the effect of collaborative care on
depression, anxiety, and stress of patients after
coronary angioplasty. Medical-Surgical Nursing
Journal. 2016;5(2):51-7.
29. Molazem Z, Rezaei S, Mohebbi Z, Ostovan MA, Keshavarzi S. Effect of continuous care
model on lifestyle of patients with myocardial
infarction. ARYA atherosclerosis.
2013;9(3):186.
30. Moattari M, Adib F, Kojuri J, Tabatabaee SHR.
Angina self-management plan and quality of
life, anxiety and depression in post coronary
angioplasty patients. Iranian Red Crescent
Medical Journal. 2014;16(11).