Development of an integrated cardiac rehabilitation program to improve the adaptation level of patients after acute myocardial infarction

Health Literacy Profiles of Caregivers of Acute Myocardial Infarction Patients

BACKGROUND

Health literacy among caregivers of patients with myocardial infarction is a crucial area that is still not fully addressed in research.

OBJECTIVE

In this study, our aim was to explore the health literacy profiles of caregivers of patients with acute myocardial infarction (AMI).

METHODS

A cross-sectional design was used, involving 121 caregivers of patients with AMI recruited through convenience sampling. Data were collected using a demographics questionnaire and the Health Literacy Questionnaire. Hierarchical cluster analysis was performed to determine health literacy profiles based on Health Literacy Questionnaire scores and sociodemographic characteristics.

RESULTS

Six distinct clusters of health literacy profiles emerged from the analysis. Caregivers in cluster 1 exhibited the highest health literacy levels, whereas those in cluster 6 had the lowest health literacy scores with significant difficulties in understanding and using health information. Caregivers' sociodemographic factors such as age, gender, smoking status, and education level played a significant role in determining health literacy profiles.

CONCLUSION

The study highlights the diverse health literacy profiles among caregivers of patients with AMI, emphasizing the importance of designing tailored interventions to address these differences to improve the health outcomes of caregivers and patients.

Understanding adaptive tasks in cardiac rehabilitation among patients with acute myocardial infarction: a qualitative study

BACKGROUND

While Cardiac Rehabilitation (CR) programs have shown effectiveness in improving cardiac outcomes, there is limited understanding of how patients perceive and adapt to these interventions. Furthermore, alternative modes of delivering CR that have received positive evaluations from participants remain underexplored, yet they have the potential to enhance CR uptake.

OBJECTIVES

To explore the patient experience in CR programmes following Acute Myocardial Infarction (AMI) and describe their adaptive processing.

PATIENTS AND METHODS

This qualitative study was conducted at a nationally certified centre in China between July 2021 and September 2022, encompassing three stages: in-hospital, centre-based, and home-based CR programs. Purposive sampling was used to select eligible AMI patients for in-depth semi-structured interviews. The interview outline and analytical framework were aligned with the key concepts derived from the middle-range theory of adaptation to chronic illness and the normalization process theory. The findings were reported following the Consolidated Criteria for Reporting Qualitative Research checklist.

RESULTS

Forty AMI patients were recruited. Four main themes describing the process of AMI patients normalizing CR intervention were identified, including (1) experiencing CR service driving by role's responsibilities, (2) engaging in collaborative relationship based on interpersonal trust, (3) exploring a personalized rehabilitation plan by complex integration, and (4) expecting a promised outcome to shape decision-making.

CONCLUSION

Integrated care interventions for AMI patients could benefit from a collaborative co-designed approach to ensure that CR interventions are normalized and fit into patients' daily lives. Organizational-level CR services should align with the rehabilitation needs and expectations of patients.

Lived experiences of older adults within an integrated hospital-at-home service: an interpretive phenomenological analysis

BACKGROUND

The Hospital at Home (HaH) service has developed and evolved over the past few years with the Covid-19 pandemic and improved the integration of care in the community from acute hospital settings. Despite these advancements, there remains a limited understanding of patients' lived experiences with the HaH service. This study aims to explore the experiences and perceptions of older adults who have received HaH services to inform future quality improvement initiatives.

METHODS

A qualitative approach utilizing semi-structured interviews was employed to comprehensively understand how patients and family caregivers individually interpreted and made sense of their interactions with the HaH service in the context of an urban setting in the United Kingdom. Purposive sampling was used to select key informants (n = 7) who had previously utilized the HaH service in early 2023. Using an interpretive phenomenological analysis, approaches of interpretive interviews, initial data review, segmentation of data into coherent units, and condensation into cohesive themes were involved. Reporting of findings adhered to the Standards for Reporting Qualitative Research (SRQR) Guidelines.

RESULTS

Four distinct themes, each accompanied by its own set of interpretive practices and subordinate themes, emerged: [1] positive experiences of using HaH service [2], supporting family-centred care within HaH service [3], perceived challenges faced by individuals and caregivers in HaH [4], messages for quality improvement of HaH service.

CONCLUSIONS

The study's findings provide insight into the experiences and interpretations of users within an integrated HaH service. The positive aspects of the service, its encouragement of family-centred care, identified challenges, and suggested improvements collectively contribute to advancing the quality enhancement of future HaH endeavours.

The Association of Health Literacy With the Quality of Discharge Planning and Readiness for Hospital Discharge in Jordanian Acute Myocardial Infarction Patients

AIM

To examine the relationship between health literacy with the quality of discharge planning and readiness for hospital discharge in acute myocardial infarction patients in Jordan.

BACKGROUND

Acute myocardial infarction is a major heart disease caused by plaque formation in coronary arteries. Complications after acute myocardial infarction include readmission and physical complications such as chest pain, and limited health literacy increases the risk of complications. Improving the health literacy of patients can improve postdischarge outcomes and decrease complications.

METHODS

This study was conducted using a cross-sectional design. Data were collected from 123 patients who were recruited from three hospitals in Jordan. A demographics questionnaire and three valid and reliable instruments (Health Literacy Questionnaire, Readiness for Hospital Discharge Scale and Quality of Discharge Teaching Scale) were used to collect the data. The authors adhered to the STROBE checklist during the preparation of this study.

RESULTS

The results demonstrated that the Readiness for Hospital Discharge had weak to moderate positive correlations with health literacy scales (r = 0.24-0.36, p < 0.05). The content subscale of the Quality of Discharge Teaching Scale showed weak positive correlations with navigating the healthcare system, finding good health information and understanding health information scales of the Health Literacy Questionnaire.

CONCLUSION

The results reported here indicate that health literacy positively correlates with readiness for hospital discharge and quality of discharge teaching.

RELEVANCE TO CLINICAL PRACTICE

Improving the health literacy of acute myocardial infarction patients can enhance their discharge planning outcomes. The findings of this study are beneficial for healthcare providers in designing targeted interventions that correspond to health literacy among acute myocardial infarction patients.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Identifying Health Literacy Strengths and Needs Among Jordanian Acute Myocardial Infarction Patients

Acute myocardial infarction is a significant health issue, particularly in Jordan where ischemic heart disease is the leading cause of death. Effective management of acute myocardial infarction is essential to mitigate its consequences. Although health literacy is crucial for the successful management of acute myocardial infarction, research about the strengths and needs of health literacy among acute myocardial infarction patients is still limited. This study was conducted to identify the health literacy strengths and needs of Jordanian acute myocardial infarction patients using cluster analysis. A cross-sectional design was used to conduct this study in a sample of acute myocardial infarction patients in Jordan (N = 114). A demographics questionnaire and the Health Literacy Questionnaire were used to collect the data. Data analysis was performed using hierarchical cluster analysis using Ward's method. Seven distinct clusters of acute myocardial infarction patients were identified, each characterized by unique health literacy profiles and sociodemographic characteristics. Cluster 7 had the highest health literacy scores across all nine Health Literacy Questionnaire scales. Sociodemographic factors such as age, education level, and gender influenced health literacy levels, with female, younger, more educated patients exhibiting higher health literacy. Through identifying the specific strengths and needs, this research provides a foundation for developing targeted health literacy interventions for acute myocardial infarction patients. Improving health literacy among acute myocardial infarction patients can enhance their ability to manage their health and potentially reduce the complications associated with acute myocardial infarction.

Adherence to Cardiac Rehabilitation in Patients with Acute Myocardial Infarction After PCI: A Scoping Review

Purpose

Cardiac rehabilitation (CR) is a multidisciplinary intervention program aimed at enhancing the physical, psychological, and social functioning of patients with cardiovascular disease. Although CR is cost-effective and reduces mortality and readmission rates, and many patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI) do not adhere to CR. This review aimed to synthesize the evidence on adherence to CR in patients with AMI after PCI (AMI-PCI).

Patients and Methods

The review was conducted using the methodology proposed by the Joanna Briggs Institute (JBI) to guide reviews and reporting using the Preferred Reporting Items for Systematic Reviews and Meta-analyses Extended for Scoping Reviews (PRISMA-ScR). We searched PubMed, Web of Science, CINAHL, Embase, Ovid, and Scopus databases, and two reviewers independently screened the abstracts and full texts of eligible studies against the inclusion and exclusion criteria. Disagreements were resolved in consultation with a third reviewer.

Results

A total of 10 studies were included in the analysis. The results demonstrated that CR reduces the incidence of complications and improves the quality of life of patients with AMI-PCI. However, the CR adherence rate was low, and the factors affecting it are complex and varied, including age, sex, and employment status. Furthermore, interventions to improve adherence in patients with AMI-PCI mainly combined the internet-based interventions, including videoconferencing tele-training, with wearable device monitoring and intelligent management platform follow-up. All these interventions have shown promising results compared with routine care.

Conclusion

Adherence to CR in patients with AMI-PCI is generally low, and CR adherence is affected by many factors; however, relevant research designs are rare and simple. Healthcare professionals should pay more attention to adherence to CR in this population and use a variety of interventions to improve it.