Completed Research Project

Identifying and addressing education needs for patients undergoing percutaneous coronary interventions as a short stay procedure

Investigators:  Young, J., McCavana, C., Nikoletti, S., & Sheehan, M.
Funding: ECU-Industry Collaboration Scheme ($20,446) & WA Nurses Memorial Charitable Trust ($2,000).

Abstract: Coronary heart disease (CHD) is the major cause of cardiovascular disease worldwide, accounting for one third of annual mortality in both men and women. One major problem with providing education to patients with this condition is their limited in-patient stay, which is primarily due to the use of less invasive diagnostic and therapeutic procedures, such as Percutaneous Coronary Intervention (PCI). The purpose of this study was to identify and address the educational needs of patients undergoing PCI as a short stay procedure. The project consisted of three stages: (1) identification of information needs and the extent to which these had been met; (2) development of an improved information needs assessment tool, and educational resources; and (3a) to evaluate the improved assessment and educational resources in relation to content and delivery; and (3b) to identify the educational needs and unmet needs of patients undergoing PCI as a short stay procedure and compare the types and percentage of selected information needs with those for Stage 1. The study used a cross sectional research design conducted in three stages over 24 months, with a convenience sample of 223 PCI patients (n=95 Stage 1; n=128 Stage 3) who were undergoing PCI as a short stay procedure at SCGH. All patients were 18 years or older and able to read and understand English. Seventy-four cardiac catheter (CC) patients completed a telephone interview or questionnaire and 21 angioplasty patients returned completed questionnaires for Stage 1. Ages ranged from 22 to 82 years (M=63 years). Results showed that although CC patients acknowledged receiving information on how to recover from their procedure, more information on exercise, coronary artery disease and risk factors was requested. Angioplasty patients’ discharge information requests were primarily for information on appropriate exercise regimens. In Stage 2 of the study, the development of the clinical assessment tool and improved educational resources were guided by results obtained in Stage 1 of the study. The resources were also pilot tested prior to dissemination. In Stage 3 the sample consisted of 128 participants, the majority (n= 105) of whom underwent cardiac catheterisation. The mean age for both groups was 64 years (SD=10). The majority of angioplasty patients stated that they were given enough information with regard to pathophysiology, side effects, and procedural information (94-100%), but requested more information on risk factors such as management of blood pressure and exercise. Fewer CC patients stated that they had enough information with regard to pathophysiology, side effects, and procedural information (58- 93%). Additionally, between 8 to 42% of CC patients requested information on risk factors for CHD. Angioplasty patients were knowledgeable on CHD risk factors but less knowledgeable on procedural information. CC patients responded similarly. Specifically, CC patients incorrectly reported that a CC procedure would: unblock an artery (35%; n=37); prevent plaque build-up on the artery wall (19%; n=20); and cure their heart condition (21%; n=20). In conclusion, short stay PCI patients need to be better educated to enable them to make appropriate lifestyle choices and be fully informed about the procedures which they consent to undergo. Information from this study may assist clinicians to improve the education given to patients undergoing these short stay procedures.