Dataset Information

Evaluating the effectiveness of a comprehensive patient education intervention in a hybrid model of cardiac rehabilitation: A pilot study.

ABSTRACT:

Objective

To evaluate the effectiveness of a comprehensive educational intervention in a hybrid model of cardiac rehabilitation in Spain during the COVID-19 pandemic.

Methods

In a prospective pretest-posttest pilot study a pooled sample of patients attending hybrid cardiac rehabilitation in Spain received a culturally-adapted education intervention for 6 weeks. Participants completed surveys at pre- and post-rehabilitation assessing disease-related knowledge, health literacy, adherence to the Mediterranean Diet and self-efficacy. Physical activity was measured by number of steps per day using wearable activity tracking devices. Satisfaction with the educational materials was also evaluated by a survey with a 10 point Likert-type scale and yes/no and open-ended questions.

Results

Eighty-one(99%) participants completed both assessments. There was significant improvement in disease-related knowledge(p < 0.001), physical activity(p < 0.001), and adherence to the diet(p = 0.005) post-rehabilitation. The number of participants that were classified as having "high health literacy skills" increased by 17%. Post-rehabilitation knowledge was associated with education level (ß = 0.430; p = 0.001),pre-rehabilitation knowledge (ß = 0.510; p = 0.002), and high health literacy skills (ß = 0.489; p = 0.01). Educational materials were highly satisfactory to participants.

Conclusion

Significant increases in disease-related knowledge and health behaviors in patients attending hybrid models of cardiac rehabilitation are encouraging results that support the value of implementing comprehensive educational initiatives to programs in Spain.

Innovation

This work presents preliminary evidence of the effectiveness of the first comprehensive education intervention that is open access and culturally adapted to people living with cardiovascular disease in Spain.

SUBMITTER: Arrieta-Bartolome G

PROVIDER: S-EPMC9150916 | biostudies-literature | 2022 Dec

REPOSITORIES: biostudies-literature

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Publications

Evaluating the effectiveness of a comprehensive patient education intervention in a hybrid model of cardiac rehabilitation: A pilot study.

Arrieta-Bartolomé Gustavo G Supervia Marta M Velasquez Alessandra Bertha Castillo ABC Delgado-Montero Antonia A Méndez Irene I Orduñez Mª Ángeles Ortega MÁO Arroyo-Riaño Olga O Aultman Crystal C Oh Paul P Ghisi Gabriela Lima de Melo GLM

PEC innovation 20220530

<h4>Objective</h4>To evaluate the effectiveness of a comprehensive educational intervention in a hybrid model of cardiac rehabilitation in Spain during the COVID-19 pandemic.<h4>Methods</h4>In a prospective pretest-posttest pilot study a pooled sample of patients attending hybrid cardiac rehabilitation in Spain received a culturally-adapted education intervention for 6 weeks. Participants completed surveys at pre- and post-rehabilitation assessing disease-related knowledge, health literacy, adhe ...[more]

PMID: 35663291

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Project description:ObjectivesPatient education and compliance play an important role in the success of rehabilitation in cardiovascular diseases. The aim of this study is to analyze whether interactive learning methods, in this study, the audience response system with a "clicker," can improve the learning success of patients during and after their rehabilitation process.MethodsIn a randomized, prospective cohort study, a total of 260 patients were randomized to either an interactive training group using Athens audience response system or to a control group without the use of audience response system during the educational sessions. Patients were taught and tested on four different topics concerning their primary disease: heart failure, arterial hypertension, prevention of cardiovascular diseases, and coronary heart disease. After each session, the patients had to answer questions on the previously taught topics via questionnaires. These questions were asked again at the day of discharge, as well as 3 and 12 months after discharge. Additional information on the patients' health, plus their mental status, was gathered with the help of further questionnaires (HADS and SF-12).ResultsA total of 260 patients (201 men and 59 women) were recruited. The patients were on average 61.1 ± 11 years old. A significant short-term effect on the patients' knowledge about their disease was found immediately after the educational sessions in the intervention group. However, there was no long-term effect in either the intervention or control group. Although there was no statistical significance found in any of the observations, a positive short-term effect on learning capacity as well as positive trends in mental and physical health after discharge could be found in patients after the use of audience response system during their rehabilitation.ConclusionThis study provides interesting and new data on the use of an interactive learning method for patients to gain knowledge about their primary disease and eventually improve their physical and mental health status in a long-term perspective. By implementing different and new ways of teaching and interaction during the hospitalization, not only patients, but also medical staff and caregivers could benefit.

Project description:IntroductionAir pollution poses significant risks to cardiovascular health, yet patients often lack comprehensive knowledge about its impact and mitigation strategies. This study aims to evaluate the effectiveness of an educational intervention within a cardiac rehabilitation (CR) context in enhancing patients' understanding of air pollution and its cardiovascular effects.MethodsA pre-post pilot study was conducted from February 2021 to June 2021 at the Gregorio Marañón University General Hospital, Madrid, Spain. A total of 43 patients with cardiovascular disease attending CR were enrolled. Participants received a 1-h educational intervention delivered either in-person or online, focusing on the effects of air pollution and strategies to reduce exposure. Pre- and post-intervention questionnaires assessed participants' knowledge and perceptions. Descriptive statistics were used to analyze changes in awareness and understanding.ResultsInitially, participants demonstrated a high level of awareness about the health impacts of air pollution, with 100% acknowledging its effects on health. However, detailed knowledge about specific concepts such as the Air Quality Index (AQI) and particulate matter (PM2.5) was limited. Post-intervention, there was a significant increase in knowledge, with familiarity with AQI rising from 61% to 81% (p = 0.02) and understanding of PM2.5 improving from 28% to 58% (p = 0.01). This indicates that the educational intervention effectively bridged gaps in understanding and reinforced the importance of environmental factors in cardiovascular health management.DiscussionThe pilot study highlights the critical role of targeted education in improving patient awareness and knowledge about air pollution. The significant improvement in understanding key concepts underscores the need for broader educational initiatives that extend beyond CR programs. Future research should explore the impact of such interventions on long-term health outcomes and consider expanding educational efforts to include healthcare providers and family members.

Project description:IntroductionPhysical inactivity is a risk factor for repeat cardiac events and all-cause mortality in coronary heart disease (CHD). Cardiac rehabilitation, a secondary prevention programme, aims to increase physical activity levels in this population from a reported low baseline. This trial will investigate the effectiveness and implementation of a very brief physical activity intervention, comparing different frequencies of physical activity measurement by cardiac rehabilitation clinicians. The Measure It! intervention (<5 min) includes a self-report and objective measure of physical activity (steps) plus very brief physical activity advice.Methods and analysisThis type 1 hybrid effectiveness-implementation study will use a two-arm multicentre assessor-blind randomised trial design. Insufficiently active (<150 min of moderate-to-vigorous physical activity per week) cardiac rehabilitation attendees with CHD (18+ years) will be recruited from five phase II cardiac rehabilitation centres (n=190). Patients will be randomised (1:1) to five physical activity measurements or two physical activity measurements in total over 24 weeks. The primary effectiveness outcome is accelerometer daily minutes of moderate-to-vigorous intensity physical activity at 24 weeks. Secondary effectiveness outcomes include body mass index, waist circumference and quality-of-life. An understanding of multilevel contextual factors that influence implementation, and antecedent outcomes to implementation of the intervention (eg, feasibility and acceptability), will be obtained using semistructured interviews and other data sources. Linear mixed-effects models will be used to analyse effectiveness outcomes. Qualitative data will be thematically analysed inductively and deductively using framework analysis, with the framework guided by the Consolidated Framework for Implementation Research and Theoretical Domains Framework.Ethics and disseminationThe study has ethical approval (University of Canberra (ID 11836), Calvary Bruce Public Hospital (ID 14-2022) and the Greater Western Area (ID 2022/ETH01381) Human Research Ethics Committees). Results will be disseminated in multiple formats for consumer, public and clinical audiences.Trial registration numberACTRN12622001187730p.

Project description:Coronary heart disease (CHD) is a leading cause of death in the UK. Clinical guidelines recommend cardiac rehabilitation (CR), including health education, cardiovascular risk reduction advice, physical activity and stress management components. However, uptake of standard in-person, group-based CR is only around 50%. Hybrid cardiac rehabilitation (CR), combining in-person and remote service delivery, may improve CR uptake and reduce inequalities in service access. This study used focus groups and semi-structured interviews to explore staff and patient experiences of using the Active+me REMOTE hybrid CR app, a cloud-based platform providing access to education modules, behaviour change support, live exercise classes, physical activity and health monitoring across three sites in the East of England. Twelve staff and six patients participated. Topic guides explored participants' experiences of delivering or receiving hybrid CR, barriers and facilitators associated with the hybrid CR pathway, and implications for future implementation of Active+me REMOTE. Qualitative data were collected remotely, audio-recorded and independently transcribed. Staff data were analysed deductively, using the Consolidated Framework for Implementation Research (CFIR). Patient data were analysed inductively using thematic analysis. Despite some technical issues and governance delays, Active+me REMOTE was perceived as acceptable, convenient and allowed tailoring of support to meet patients' needs and circumstances. Data upload from wearable devices (blood pressure monitors) allowed staff to monitor patients' progress and empowered patients to direct their recovery. Staff initially felt they should screen patients to ensure that hybrid CR was offered to digitally literate, physically active individuals, although screening became less common as staff familiarity with the app increased. Findings suggest that effective implementation of hybrid CR requires system-level resource to facilitate governance approvals and embed hybrid CR delivery as standard care. Sufficient time must be allowed for staff training and to support patient enrolment to hybrid services. The study was registered on 3/7/2023 (ISRCTN320764).

Project description:BackgroundCardiac rehabilitation (CR) is clinically proven to reduce morbidity and mortality; however, many eligible patients do not enroll in treatment. Furthermore, many enrolled patients do not complete their full course of treatment. This is greatly influenced by socioeconomic factors but is also because of patients' lack of understanding of the importance of their care and a lack of motivation to maintain attendance.ObjectiveThis study aims to explore the potential benefits of virtual reality (VR) walking trails within CR treatment, specifically with regard to patient knowledge retention, satisfaction with treatment, and the overall attendance of treatment sessions.MethodsNew CR patients were enrolled and randomized on a rolling basis to either the control group or intervention group. Intervention patients completed their time on the treadmill with VR walking trails, which included audio-recorded education, whereas control patients completed the standard of care therapy. Both groups were assisted by nursing staff for all treatment sessions. Primary outcomes were determined by assessing 6-minute walk test improvement. In addition, secondary outcomes of patients' cardiac knowledge and satisfaction were assessed via a computer-based questionnaire; patient adherence to the recommended number of sessions was also monitored. Cardiac knowledge assessment included a prerehabilitation education quiz, and the same quiz was repeated at patients' final visit and again at the 2-month follow-up. The satisfaction questionnaire was completed at the final visit.ResultsBetween January 2018 and May 2019, 72 patients were enrolled-41 in the intervention group and 31 in the control group. On the basis of the results of the prerehabilitation and postrehabilitation 6-minute walk test, no significant differences were observed between the intervention and control groups (P=.64). No statistical differences were observed between groups in terms of education (P=.86) or satisfaction (P=.32) at any time point. The control group had statistically more favorable rates of attendance, as determined by the risk group comparison (P=.02) and the comparison of the rates for completing the minimum number of sessions (P=.046), but no correlation was observed between the study group and reasons for ending treatment.ConclusionsAlthough no improvements were seen in the VR intervention group over the control group, it is worth noting that limitations in the study design may have influenced these outcomes, not the medium itself. Furthermore, the qualitative information suggests that patients may have indeed enjoyed their experience with VR, even though quantitative satisfaction data did not capture this. Further considerations for how and when VR should be applied to CR are suggested in this paper.Trial registrationClinicalTrials.gov NCT03945201; https://clinicaltrials.gov/ct2/show/NCT03945201.

Project description:IntroductionLiterature suggests that patient engagement in healthy lifestyle is of crucial importance in ensuring a more effective management of side effects of cancer therapies and better quality of life for patients. While many studies describe educational interventions to promote healthy lifestyles, few are focused on promoting active patient engagement in this field. This protocol paper outlines a study to determine the feasibility of a complex nurse-led patient education intervention aimed to promote cancer patient engagement in a healthy lifestyle.Method and analysisThis is a randomised pilot and feasibility study. Research nurses will recruit 40 adult patients newly diagnosed with cancer. Consenting participants will be randomised to undergo the patient engagement in healthy lifestyle intervention or the control group by means of a four-block randomisation procedure. The intervention will be delivered by a clinical nurse trained in patient engagement strategies. The primary outcome will be a description of study feasibility (recruitment and retention rates, protocol adherence and stakeholder acceptability). Secondary outcomes include changes between and within groups in healthy lifestyle behaviours (ie, increase in healthy diet, smoke cessation or reduction, increase in physical activity), in quality-of-life rates after the intervention, in patient engagement levels, in the perception of the quality of care, in nutritional status; the number of recurrences or the onset of new cancer diagnosis; the number of hospitalization.Ethics and disseminationThe study protocol has been approved by the Canton Ticino Ethical Committee (Protocol ID: 2020-02477 TI). The results will be published in peer-reviewed journals and will be presented at national and international congresses. Finally, patients' organisations, such as the Swiss Cancer League, will be involved in the dissemination process. This study will inform the decision to proceed with a randomised controlled trial to assess the effect of this intervention.

Dataset Information

Evaluating the effectiveness of a comprehensive patient education intervention in a hybrid model of cardiac rehabilitation: A pilot study.

Objective

Methods

Results

Conclusion

Innovation

Publications

Evaluating the effectiveness of a comprehensive patient education intervention in a hybrid model of cardiac rehabilitation: A pilot study.

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