Chulalongkorn Medical Journal


Introductions : Initially diagnosed coronary heart disease (CHD) patients experience new form of life-threatening illness which includes various health problems that significantly contribute to low health-related quality of life (HRQOL). Low HRQOL impacts the recovery process, decrease compliance with treatments, and causes a higher rate of hospital readmission for numerous complications and/or death. Selfmanagement intervention is most successful in promoting outcome of health including HRQOL. Comprehensive cardiac nursing program (CCNP) has been developed with its emphasis on patient's management of risky health behavior, in order to improve their HRQOL. Objectives : To evaluate the effectiveness of CCNP on HRQOL in firstly diagnosed CHD patients. Settings : Two secondary healthcare settings in Thailand. Research design : Randomized control trial. Samples There were 74 eligible patients who received their first diagnosis as CHD. Methods : The subjects were randomly assigned by block randomization. Thirty-seven participants in the experimental group received CCNP together with their usual care, whereas 37 participants in the control group received only their usual care. The experimental group underwent 4 phases which were: 1) the risky health behavior assessment; 2) preparation phase; 3) practice phase; and, 4) evaluation phase. HRQOL was evaluated by Quality of Life Index, Cardiac version IV on the second day of admission and at 8 weeks after discharge. Results : HRQOL scores and the percentage of change in the overall and all domains of health and functioning, social and economic, psycho and spiritual, and family of the participants who received the CCNP in the experimental group had significantly higher than the participants who received usual care in the control group (p <.05). Conclusions : The comprehensive cardiac nursing program was effective for improvement of HRQOL in patients firstly diagnosed with CHD.



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