Evaluation of a brief educational intervention to improve knowledge of sublingual nitroglycerin in cardiac rehabilitation patients

Patient and family perceptions and experiences of same-day discharge following percutaneous coronary intervention and those kept overnight

OBJECTIVE

To explore perceptions and experiences of patients discharged the same day (or not) and their family members towards same-day discharge following percutaneous coronary intervention.

DESIGN AND METHODS

A qualitative interpretative design. Semi-structured phone interviews were conducted with consented patients who underwent percutaneous coronary intervention, and their family members (n = 23). Data were analysed using a content analysis approach.

SETTING

This study was undertaken in the cardiac services department of an Australian tertiary hospital.

MAIN OUTCOME MEASURES

Perceptions and experiences of same-day discharge.

FINDINGS

A total of 31 patients and 23 family members were interviewed. Two categories emerged from the analysis: communication challenges with hospital staff and perceptions of same-day discharge. Family members were often not provided discharge instructions, and some same-day discharged patients felt vulnerable following discharge. When asked, most participants perceived same-day discharge as a preferred option because of its comfort and convenience. Some expressed uncertainty towards same-day discharge due to feeling anxious and apprehensive. Others misperceived same-day discharge as a signal that their heart problem was fixed without realising their underlying chronic health conditions.

CONCLUSION

Most patients and family members perceived same-day discharge as a preferred option. However, strategies are needed to support their transition from hospital to home, therefore, recognising and improving their long-term disease management.

Target Audience and Preferences Related to an Australian Coronary Heart Disease Specific Mobile App: A Mixed Methods Study

BACKGROUND

Widespread availability of mobile technologies offers the opportunity to support secondary prevention of coronary heart disease (CHD) via mobile apps, however, the target audience and their app preferences are unknown. This study aims to identify the potential audience for an Australian CHD specific app and their recommendations and preferences.

METHODS

A two-phase mixed methods study: Phase 1: CHD patients (n=282) were surveyed on mobile app engagement. Phase 2: Four focus groups with regular app users (n=12) identified preferences and recommendations generated after using a CHD-specific publicly available app (MyHeartMyLife) for 2 weeks. Data were thematically analysed.

RESULTS

Survey participants were aged ≥56 years (238/282, 84.4%) and male (204/282, 72.3%). More than one third (108/282, 38.3%) were regular app users, of whom 83/108, (76.9%) used health apps. Regular app users were more likely to be <56 years (versus ≥70 years; OR 4.70, 95% CI 1.92, 11.51), employed (OR 3.07, 95% CI 1.63, 5.77) and had completed high school education (OR 2.37, 95% CI 1.30, 4.34). Focus group participants using the CHD-specific app were aged 41-79 years (mean 62.2 SD 5.3 years) and 10/12 were male. Coronary heart disease specific app preferences generated included: immediate access to relevant and practical health information and records; behaviour change motivation; more experienced app users located and used app features readily and provided support for less experienced users. In addition, ensuring ease of reading and interpreting data, adding physical activity tracking, the ability to integrate and synchronise with other apps and devices, and capacity to store additional personal medical records were also recommended.

CONCLUSIONS

The target audience for CHD-specific apps is aged <56 years, employed, has completed high school and is an experienced app user. User preferences and recommendations identified features present in publicly available apps, but many features need development.

Mobile Technology Use Across Age Groups in Patients Eligible for Cardiac Rehabilitation: Survey Study

Background

Emerging evidence indicates mobile technology–based strategies may improve access to secondary prevention and reduce risk factors in cardiac patients. However, little is known about cardiac patients’ use of mobile technology, particularly for health reasons and whether the usage varies across patient demographics.

Objective

This study aimed to describe cardiac patients’ use of mobile technology and to determine variations between age groups after adjusting for education, employment, and confidence with using mobile technology.

Methods

Cardiac patients eligible for attending cardiac rehabilitation were recruited from 9 hospital and community sites across metropolitan and rural settings in New South Wales, Australia. Participants completed a survey on the use of mobile technology devices, features used, confidence with using mobile technology, willingness and interest in learning, and health-related use.

Results

The sample (N=282) had a mean age of 66.5 (standard deviation [SD] 10.6) years, 71.9% (203/282) were male, and 79.0% (223/282) lived in a metropolitan area. The most common diagnoses were percutaneous coronary intervention (33.3%, 94/282) and myocardial infarction (22.7%, 64/282). The majority (91.1%, 257/282) used at least one type of technology device, 70.9% (200/282) used mobile technology (mobile phone/tablet), and 31.9% (90/282) used all types. Technology was used by 54.6% (154/282) for health purposes, most often to access information on health conditions (41.4%, 117/282) and medications (34.8%, 98/282). Age had an important independent association with the use of mobile technology after adjusting for education, employment, and confidence. The youngest group (<56 years) was over 4 times more likely to use any mobile technology than the oldest (>69 years) age group (odds ratio [OR] 4.45, 95% CI 1.46-13.55), 5 times more likely to use mobile apps (OR 5.00, 95% CI 2.01-12.44), and 3 times more likely to use technology for health-related reasons (OR 3.31, 95% CI 1.34-8.18). Compared with the older group, the middle age group (56-69 years) was more than twice as likely to use any mobile technology (OR 2.42, 95% CI 1.27-4.59) and mobile technology for health-related purposes (OR 1.92, 95% CI 1.04-3.53). Participants who had completed high school were twice as likely to use mobile technology (OR 2.62, 95% CI 1.45-4.70), mobile apps (OR 2.05, 95% CI 1.09-3.84), and mobile technology for health-related reasons (OR 5.09, 95% CI 2.89-8.95) than those who had not completed high school. Associations were also present between participants living in metropolitan areas and mobile technology use (OR 1.07, 95% CI 1.07-4.24) and employment and mobile app use (OR 2.72, 95% CI 1.44-5.140).

Conclusions

Mobile technology offers an important opportunity to improve access to secondary prevention for cardiac patients, particularly when modified to suit subgroups. High levels of mobile technology use and health motivation need to be harnessed for secondary prevention.

Cardiac Patients' Experiences and Perceptions of Social Media: Mixed-Methods Study

Background

Traditional in-person cardiac rehabilitation has substantial benefits for cardiac patients, which are offset by poor attendance. The rapid increase in social media use in older adults provides an opportunity to reach patients who are eligible for cardiac rehabilitation but unable to attend traditional face-to-face groups. However, there is a paucity of research on cardiac patients’ experiences and perspectives on using social media to support their health.

Objective

The aim of this study was to describe cardiac rehabilitation patients’ experiences in using social media in general and their perspective on using social media, particularly Facebook, to support their cardiac health and secondary prevention efforts.

Methods

A mixed-methods study was undertaken among cardiac rehabilitation patients in both urban and rural areas. First, this study included a survey (n=284) on social media use and capability. Second, six focus group interviews were conducted with current Facebook users (n=18) to elucidate Facebook experience and perspectives.

Results

Social media use was low (28.0%, 79/282) but more common in participants who were under 70 years of age, employed, and had completed high school. Social media users accessed Web-based information on general health issues (65%, 51/79), medications (56%, 44/79), and heart health (43%, 34/79). Participants were motivated to invest time in using Facebook for “keeping in touch” with family and friends and to be informed by expert cardiac health professionals and fellow cardiac participants if given the opportunity. It appeared that participants who had a higher level of Facebook capability (understanding of features and the consequences of their use and efficiency in use) spent more time on Facebook and reported higher levels of “liking,” commenting, or sharing posts. Furthermore, higher Facebook capability appeared to increase a participants’ willingness to participate in a cardiac Facebook support group. More capable users were more receptive to the use of Facebook for cardiac rehabilitation and more likely to express interest in providing peer support. Recommended features for a cardiac rehabilitation Facebook group included a closed group, expert cardiac professional involvement, provision of cardiac health information, and ensuring trustworthiness of the group.

Conclusions

Cardiac health professionals have an opportunity to capitalize on cardiac patients’ motivations and social media, mostly Facebook, as well as the capability for supporting cardiac rehabilitation and secondary prevention. Participants’ favored purposeful time spent on Facebook and their cardiac health provides such a purpose for a Facebook intervention. The study results will inform the development of a Facebook intervention for secondary prevention of cardiovascular disease.