The relationship between illness perceptions and cardiac misconceptions after Myocardial Infarction

Association between illness perception and clinical control, quality of life, physical activity, and psychosocial status in subjects with moderate to severe asthma: a cluster analysis

Background: Illness perception (IP) is a psychosocial factor involved in several chronic diseases and is associated with relevant clinical outcomes. However, the relationship between IP and health-related quality of life (HRQoL), psychosocial status, and physical activity in daily life (PADL) in subjects with asthma is poorly understood.Objective: To identify groups of subjects with asthma based on their IPs and to assess their association with clinical control, HRQoL, psychosocial disturbances, and PADL.Methods: This cross-sectional study included 149 subjects with moderate to severe asthma. IP, anthropometric data, Asthma Control Questionnaire-7, Asthma Quality of Life Questionnaire, Hospital Anxiety and Depression Scale, PADL (accelerometry), and general self-efficacy (GSE) were assessed. Cluster analysis was performed to identify clusters with similar profiles and investigate their characteristics and differences. Pearson's correlation coefficient was used to test the associations between IP and other variables.Results: Statistical analyses identified two clusters of subjects with asthma based on IP. Cluster 1 presented worse IP in seven out of eight domains than Cluster 2. Cluster 1 had more negative consequences of the disease, worse understanding, and a high emotional representation of the disease than Cluster 2. Cluster 1 also had a greater extent of asthma symptoms, poor clinical control, worse HRQoL, and more symptoms of anxiety and depression. No difference between clusters was found for PADL or self-efficacy.Conclusion: Subjects with asthma who have worse IP have more negative symptoms, worse clinical control, HRQoL, and symptoms of anxiety and depression.

Cardiac health knowledge and misconceptions among nursing students: implications for nursing curriculum design

BACKGROUND

Cardiac misconceptions are common among healthcare professionals. The development of professional knowledge is considered an essential component of nursing education. Nurses, regardless of their grade, skills, and experience, should be updated with information so as to be able to rectify their misconceptions, as these could affect patient health outcomes. As the literature evaluating the cardiac knowledge and misconceptions of nursing students is sparse, a study of the subject seems warranted.

METHODS

A cross-sectional sample survey was used to study the cardiac knowledge and cardiac misconceptions of nursing students in Hong Kong. The study sample included 385 senior nursing students from three universities. Their level of knowledge of cardiac disease was assessed using the modified Coronary Heart Disease Knowledge Test. The York Cardiac Beliefs Questionnaire (YCBQv1) was used to examine cardiac misconceptions.

RESULTS

The scores for the nursing students' level of knowledge were diverse. Their mean score in the Cardiac Knowledge Test was 12.27 out of 18 (SD 2.38), with a range of 2-17. For cardiac misconceptions, their mean score in the YCBQv1 was 6.98 out of 20 (SD 2.84), with a range of 0-14. A negative correlation, r = -0.33 was found among students with more knowledge and fewer misconceptions. (p < 0.001). The Chi-square tests found some associations between the students' experiences of caring for cardiac patients and misconceptions about stress and physiology.

CONCLUSIONS

The results of our analyses indicate a diversity in levels of knowledge among the nursing students. Students with higher scores in cardiac knowledge did not necessarily have fewer misconceptions. There were associations between the students' misbeliefs and their caregiving experiences with cardiac patients. This study presents a framework for designing the contents of cardiac nursing programmes and is a starting point for promoting research on misconceptions held by undergraduate nursing students. A new paradigm of teaching should include inputs from both perspectives to help students to make critical use of theoretical knowledge to rectify their misconceptions and pursue excellence in the working world.

Randomized controlled trial of an intervention to change cardiac misconceptions in myocardial infarction patients

There is converging evidence that changing beliefs about an illness leads to positive recovery outcomes. However, cardiac misconceptions interventions have been investigated mainly in Angina or Coronary Heart Disease patients, and less in patients following Myocardial Infarction (MI). In these patients, cardiac misconceptions may play a role in the adjustment or lifestyle changes. This article reports a randomized controlled trial of an intervention designed to reduce the strength of misconceptions in patients after a first MI. The primary outcome was the degree of change in misconceptions and the secondary outcomes were: exercise, smoking status, return to work and mood (anxiety and depression). Patients in the intervention condition (n = 60) were compared with a control group (n = 67) receiving usual care. Both groups were evaluated at baseline and 4, 8 and 12 months after hospital discharge. There was a significant time-by-group interaction for the total score of cardiac misconceptions. Patients in the intervention group significantly decreased their total score of cardiac misconceptions at 4 months compared with the control group and this difference was sustained over time. Patients in the intervention group were also more likely to exercise at the follow-up period after MI than the control group. This intervention was effective in reducing the strength of cardiac misconceptions in MI patients and had a positive impact on health behaviour outcomes. These results support the importance of misconceptions in health behaviours and the utility of belief change interventions in promoting health in patients with Myocardial Infarction.