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Article: Effects of a Narrative-Based Psychoeducational Intervention to Prepare Patients for Responding to Acute Myocardial Infarction: A randomized clinical trial

TitleEffects of a Narrative-Based Psychoeducational Intervention to Prepare Patients for Responding to Acute Myocardial Infarction: A randomized clinical trial
Authors
Issue Date28-Oct-2022
PublisherAmerican Medical Association
Citation
Jama Network Open, 2022, v. 5, n. 10, p. e2239208 How to Cite?
Abstract

Importance  Despite decades of educational efforts, patients’ prolonged delays in seeking care for symptoms of acute myocardial infarction (AMI) remain the greatest obstacle to successful management of the condition.

Objective  To compare the effects of a narrative-based psychoeducational intervention with a didactic educative approach on AMI survivors’ intention to seek care for AMI symptoms and on AMI knowledge.

Design, Setting, and Participants  A multisite randomized clinical trial recruited community-dwelling patients aged 18 years or older with a history of AMI from 4 hospitals in Hong Kong from January 1, 2018, to January 22, 2021, and followed up participants for 1 year.

Interventions  An 8-week narrative-based psychoeducational intervention aimed to create a vivid cognitive experience of complex decision-making and modeled desirable behavioral changes through nurse-led, interactive video sessions using model patients. The control group received 4 nurse-led sessions comprising education about AMI and care seeking delivered using a didactic approach.

Main Outcomes and Measures  The primary outcome was the behavioral intention between the 2 groups, reflected by participants’ attitudes and beliefs about care seeking for AMI measured using the Acute Coronary Syndrome Response Index—Chinese version. The secondary outcome was AMI knowledge.

Results  Six hundred and eight participants (mean [SD] age, 67.2 [8.3] years; 469 [77.1%] male) were randomized to either the narrative-based psychoeducation group (n = 304) or the didactic education group (n = 304). The psychoeducational intervention group reported greater positive changes than the control group in their attitudes (β = −1.053 [95% CI, −1.714 to −0.391]; P < .001) and beliefs (β = −0.686 [95% CI, −1.354 to −0.180]; P = .04) toward care seeking at the 3-month follow-up, and the difference was sustained at 12 months for both attitudes (β = −0.797 [95% CI, −1.477 to −0.117]; P = .02) and beliefs (β = −0.692 [95% CI, −1.309 to −0.012]; P = .047). There were no significant differences in AMI knowledge between the 2 study groups at the 3-month and 12-month time points.

Conclusions and Relevance  The results of this randomized clinical trial found that a novel approach of narrative-based psychoeducation was effective in improving patients’ behavioral intention to seek care for AMI symptoms. Longer-term follow-up to evaluate actual care-seeking behavior and clinical outcomes in patients with AMI is warranted to determine the sustained effects of this intervention.


Persistent Identifierhttp://hdl.handle.net/10722/330971
ISSN
2023 Impact Factor: 10.5
2023 SCImago Journal Rankings: 3.478
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorLi, PWC-
dc.contributor.authorYu, DSF-
dc.contributor.authorYan, BP-
dc.contributor.authorWong, CW-
dc.contributor.authorYue, SCS-
dc.contributor.authorChan, CMC -
dc.date.accessioned2023-09-21T06:51:39Z-
dc.date.available2023-09-21T06:51:39Z-
dc.date.issued2022-10-28-
dc.identifier.citationJama Network Open, 2022, v. 5, n. 10, p. e2239208-
dc.identifier.issn2574-3805-
dc.identifier.urihttp://hdl.handle.net/10722/330971-
dc.description.abstract<p><strong>Importance</strong>  Despite decades of educational efforts, patients’ prolonged delays in seeking care for symptoms of acute myocardial infarction (AMI) remain the greatest obstacle to successful management of the condition.</p><p><strong>Objective</strong>  To compare the effects of a narrative-based psychoeducational intervention with a didactic educative approach on AMI survivors’ intention to seek care for AMI symptoms and on AMI knowledge.</p><p><strong>Design, Setting, and Participants</strong>  A multisite randomized clinical trial recruited community-dwelling patients aged 18 years or older with a history of AMI from 4 hospitals in Hong Kong from January 1, 2018, to January 22, 2021, and followed up participants for 1 year.</p><p><strong>Interventions</strong>  An 8-week narrative-based psychoeducational intervention aimed to create a vivid cognitive experience of complex decision-making and modeled desirable behavioral changes through nurse-led, interactive video sessions using model patients. The control group received 4 nurse-led sessions comprising education about AMI and care seeking delivered using a didactic approach.</p><p><strong>Main Outcomes and Measures</strong>  The primary outcome was the behavioral intention between the 2 groups, reflected by participants’ attitudes and beliefs about care seeking for AMI measured using the Acute Coronary Syndrome Response Index—Chinese version. The secondary outcome was AMI knowledge.</p><p><strong>Results</strong>  Six hundred and eight participants (mean [SD] age, 67.2 [8.3] years; 469 [77.1%] male) were randomized to either the narrative-based psychoeducation group (n = 304) or the didactic education group (n = 304). The psychoeducational intervention group reported greater positive changes than the control group in their attitudes (β = −1.053 [95% CI, −1.714 to −0.391]; <em>P</em> < .001) and beliefs (β = −0.686 [95% CI, −1.354 to −0.180]; <em>P</em> = .04) toward care seeking at the 3-month follow-up, and the difference was sustained at 12 months for both attitudes (β = −0.797 [95% CI, −1.477 to −0.117]; <em>P</em> = .02) and beliefs (β = −0.692 [95% CI, −1.309 to −0.012]; <em>P</em> = .047). There were no significant differences in AMI knowledge between the 2 study groups at the 3-month and 12-month time points.</p><p><strong>Conclusions and Relevance</strong>  The results of this randomized clinical trial found that a novel approach of narrative-based psychoeducation was effective in improving patients’ behavioral intention to seek care for AMI symptoms. Longer-term follow-up to evaluate actual care-seeking behavior and clinical outcomes in patients with AMI is warranted to determine the sustained effects of this intervention.</p>-
dc.languageeng-
dc.publisherAmerican Medical Association-
dc.relation.ispartofJama Network Open-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.titleEffects of a Narrative-Based Psychoeducational Intervention to Prepare Patients for Responding to Acute Myocardial Infarction: A randomized clinical trial-
dc.typeArticle-
dc.identifier.doi10.1001/jamanetworkopen.2022.39208-
dc.identifier.scopuseid_2-s2.0-85141004040-
dc.identifier.volume5-
dc.identifier.issue10-
dc.identifier.spagee2239208-
dc.identifier.eissn2574-3805-
dc.identifier.isiWOS:000874882200010-
dc.identifier.issnl2574-3805-

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