Jordanian acute coronary syndrome patients' learning needs: Implications for cardiac rehabilitation and secondary prevention programs

Mental Health Factors and Lifestyle Adherence After Myocardial Infarction: An Integrative Review

BACKGROUND

Engaging in healthy lifestyle behaviors following myocardial infarction can improve clinical health outcomes and lower cardiovascular risk factors among patients. However, adhering to a healthy lifestyle after having a myocardial infarction can be challenging, especially for those experiencing poor mental health.

OBJECTIVE

Based on a conceptual model derived from Lazarus and Folkman's Theory of Stress and Coping and the Health Belief Model, this integrative review focuses on mental health factors associated with adherence to healthy lifestyle behaviors post-myocardial infarction.

METHODS

Whittemore and Knafl's integrative review method was used to search and select relevant literature from the EMBASE, PubMed, CINAHL, Scopus, and PsycINFO databases between 2013 and 2023.

RESULTS

A total of 35 articles were included in the review. Based on the Johns Hopkins Nursing Evidence-Based Practice Model criteria, 34 studies were of good quality (B). Mental health factors related to healthy lifestyle behaviors after myocardial infarction included the following: (1) personality factors and coping (eg, neuroticism, agreeableness, and optimism); (2) psychological symptoms (i.e., depression, anxiety, and fear); (3) appraisal (ie, illness perception); (4) health beliefs (ie, susceptibility, severity, benefits, barriers, cues to action, and self-efficacy); and (5) motivation. Social support and demographic characteristics were also related to adherence to healthy lifestyle behaviors.

CONCLUSIONS

This review highlights the role of mental health factors in adhering to healthy lifestyle behaviors among persons with myocardial infarction. Comprehensive theoretically based approaches are needed to develop future interventions for promoting healthy lifestyle behaviors in individuals post-myocardial infarction.

Exploring cardiopulmonary rehabilitation in the middle east and North Africa region: A narrative review of challenges and opportunities

BACKGROUND AND OBJECTIVES

Cardiopulmonary Rehabilitation (CR) is crucial for managing conditions like congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD), and post-COVID-19 complications. This review examines CR practices in the Middle East and North Africa (MENA) region, exploring challenges, disparities, and emerging trends.

METHODS

A comprehensive literature search was conducted in PubMed, Scopus, and Web of Science to identify studies published between date of inception and April 24th, 2024, focusing on CR programs, outcomes, challenges, and strategies specific to the MENA region. Data extraction included study design, population characteristics, CR interventions, and key findings.

RESULTS

CR programs in the MENA region vary widely in scope and execution. While efforts are underway to integrate CR services into national healthcare policies, significant challenges persist, including limited infrastructure, shortages of trained professionals, and cultural barriers. Emerging trends include the use of telehealth and digital monitoring tools to expand access to CR services and policy reforms aimed at improving service delivery and patient access.

CONCLUSION

CR plays a crucial role in improving the quality of life and health outcomes for cardiopulmonary patients, including those in the MENA region. However, significant challenges hinder the widespread adoption and effectiveness of CR programs. Addressing these challenges requires efforts to increase public education, reduce costs, expand funding, and enhance interprofessional collaboration. Future research should assess virtual rehabilitation, cultural adjustments, and long-term outcomes to tailor interventions to MENA's needs, ultimately enhancing CR accessibility and patient outcomes.

Determinants of health-related quality of life among patients with Ischemic heart disease

Objective

The aim of this study was to assess determinants of Health-Related Quality of Life (HRQOL) among Ischemic Heart Disease (IHD) patients.

Materials

It was a prospective study, carried out in "cardiology A" department in Fattouma Bourguiba teaching hospital in Monastir, Tunisia. Data were obtained during hospitalisation (T0) through structured interviews. HRQOL was evaluated one month after discharge (T1) using the French version of MacNew questionnaire.

Results

The mean age of the population was 51.92 ±6.4 years. The global HRQOL score was 4.80 ±0.95. In multivariate analysis, Global HRQOL had a significant positive association with in-hospital stay (β=0.440, p=0.004), number of children in charge (β=0.312, p=0.046) and type 2 diabetes (β=0.396, p=0.008) and a significant negative association with smoking pack¬/years (p/y) (β=-0.424, p=0.008).

Conclusion

This study showed several factors that may affect HRQOL in IHD patients. Identifying these factors can provide early detection of patients who tend to have worse HRQOL post-IHD.

High levels of risk factors and poor secondary prevention for coronary heart disease patients in public hospitals: A descriptive repeated measures study

BACKGROUND

Secondary prevention is a priority after coronary revascularization for effective long-term cardiovascular care. Coronary Heart Disease is a major health problem in Jordan, but little is known about the current provision of secondary prevention.

AIM

The aim of this study was to evaluate risk factors and explore the current provision of secondary Coronary Heart Disease prevention among patients presenting with first-time Coronary Heart Disease at two time points: during hospitalization (Time 1) and 6 months later (Time 2), in multicentre settings in Jordan.

METHODS

A descriptive, repeated measures research study design was applied to a consecutive sample of 180 patients with first-time Coronary Heart Disease. Demographic and clinical details were recorded from medical files. Self-administered questionnaires developed by the researchers were used to measure secondary prevention information related to Coronary Heart Disease, including secondary prevention services, lifestyle advice received and medical advice topics. A short form of the International Physical Activity Questionnaire was used to measure physical activity. Participants were assessed at Times 1 and 2.

RESULTS

Unstructured lifestyle advice given to the patients at Times 1 and 2 most frequently related to medications, smoking, diet and blood lipids control advice topics, with no statistically significant improvement in cardiovascular risk factors among patients between Times 1 and 2.

CONCLUSION

Despite an extremely high prevalence of risk factors in this population, the provision of secondary prevention is poor in Jordan, which requires urgent improvement, and the contribution of nurses' to secondary prevention should be enhanced.

Myocardial infarction patients' learning needs: Perceptions of patients, family members and nurses

PURPOSE

This descriptive study aimed to identify and compare patient with myocardial infarction, their family member, and cardiac nurse perceptions on the learning needs of patients with myocardial infarction in the acute, sub-acute, and post-acute phases.

METHODS

A total of 288 patients with myocardial infarction, 145 family members, and 40 cardiac unit nurses were enrolled in this study. Data were collected by survey method using the Cardiac Patient Learning Need Inventory (CPLNI). Data analysis was done using descriptive statistical analysis and analysis of variance.

RESULTS

The results showed that the learning needs of patients with myocardial infarction were high according to the perceptions of patients, patients' family members, and nurses. There were differences in the priority of learning that the patient need in relation to the disease and healing process.

CONCLUSION

Patients, family members, and nurses have different perceptions regarding the learning needs of patients with myocardial infarction. To create adequate intervention to meet patient's learning needs, there should be an accurate assessment. The results of this study support the importance of patient-centered, individualized education and attention to learning priorities.