Effect of Risk Factor-tailored Autonomy Enhancement Education in the First-time Middle-aged Patients undergoing Coronary Intervention: A randomized controlled trial

Abstract

Abstract Purpose It is important for middle-aged patients who have undergone acute treatment for coronary artery disease to voluntarily improve their lifestyle and risk factors throughout their lives based on their recognition as patients with chronic diseases. This study conducted individual education to improve risk factors and tried to verify its effectiveness. Methods The hypothesis was verified by applying a randomized controlled pre- and post-test design through random assignment of two groups. Middle-aged (40–64 years) patients who underwent percutaneous coronary intervention for the first time due to acute myocardial infarction or unstable angina were recruited from a university hospital in Seoul. For the experimental group, based on the Self-Determination Theory, risk factor- tailored counseling and education were provided individually for 1 hour based on the education booklet, and telephone counseling was conducted twice for 12 weeks. The control group was received usual care about risk factor recognition and the need for improvement at the time of discharge. Differences in autonomous motivation, resilience, self-care compliance and biochemical indicators measured after 12 weeks in the experimental group and the control group were compared. Data were analyzed using SPSS/WIN ver. 22.0. Results After 12 weeks in the experimental group, autonomous motivation (t = 4.46, p < .001), resilience (t = 7.08, p = .003), and self-care compliance (t = 5.56, p < .001) were significantly higher than those of the control group. Body mass index was also significantly decreased in the experimental group (t=-4.92, p = .005), but there was no significant difference in other biochemical parameters. Among the risk factors, the smoking rate was significantly lower in the experimental group than the control group after intervention (p < .001). Conclusion For middle-aged patients with first coronary intervention, risk factor-tailored education emphasizing autonomy by nurses should be provided early after discharge. Trial registration: This study was retrospectively registered in the Clinical Research Information Service and the identification number is KCT0008698(11/08/2023).