Effect of structured educational intervention booklet regarding anticoagulation therapy on knowledge among patients undergoing mechanical valve replacement in Egypt

Abstract

Background Valvular heart diseases are the principal causes of morbidity and mortality among patients with rheumatic heart diseases in Egypt. Management of these patients needs mechanical valve replacement. So, these patients require prolonged anticoagulation to prevent bleeding and thromboembolic emergencies unless international normalized ratio is maintained within the normal therapeutic range. Effectively, patient education can help in improving the patient outcomes. Aim The aim was to evaluate the effect of a structured educational intervention booklet regarding anticoagulation therapy on knowledge among patients undergoing mechanical valve replacement at a National Heart Institute in Egypt. Research design A pre/postquasiexperimental design was used in the current study. Research hypothesis The patients who were exposed to a structured educational intervention booklet regarding anticoagulation therapy among patients undergoing mechanical valve replacement would have greater knowledge than before exposure to an educational booklet. Sample: a purposive sample of 171 adult male and female patients who underwent mechanical valve replacement, received oral anticoagulation therapy, and were provided with an educational intervention booklet was included. Tools of data collection Two tools were used: a structured interview questionnaire sheet and a knowledge questionnaire. Baseline knowledge was evaluated preoperatively and immediately after exposure to an educational booklet. Results The age of 28.7% of patients ranged between 30 and 39 years, with a mean age of 37.895±10.472 years. Concerning patients’ sex and educational level, 53.2 and 39.3% were female and uneducated, respectively. Regarding comparison of patients’ knowledge before and after exposure to an educational intervention booklet regarding anticoagulation therapy, it revealed that majority of patients showed higher mean knowledge scores. So, the patients recorded higher correct answer responses after exposure to the educational booklet versus before exposure regarding benefit of anticoagulants (81.9 vs. 8.2%), normal rate of international normalized ratio ratio (93.6 vs. 3.5%), the factors that affect the effectiveness of anticoagulant drugs (94.2 vs. 4.1%), adverse effects of anticoagulants (52 vs. 2%), complications (59.6 vs. 3%), precautions (95.3 vs. 5.8%), foods that reduce the effect of anticoagulant (46.8 vs. 0%), and foods that increase the effect of anticoagulant (24 vs. 0%). Conclusion Significant improvements in patients’ knowledge scores were found after exposure to the structured educational intervention booklet regarding anticoagulation therapy. Recommendations Patient education interventions should be provided to improve patient outcomes. Furthermore, replication of the same study on a larger probability sample should be conducted at different geographical locations for data generalizability.