Effectiveness of an Educational Program to Enhance Self-care Skills After Acute Coronary Syndrome: A Quasi-Experimental Study

  • Lisa GomesEmail author
  • Gorete Reis
Conference paper
Part of the Communications in Computer and Information Science book series (CCIS, volume 1016)


Background: The aim of this study is to determine the effectiveness of an educational program to enhance self-care skills in patients after an acute coronary syndrome

Methods: A quasi-experimental pretest-posttest design was used in the study. A rehabilitation nurse provided an educational program (PEpSCA-CARE) to the intervention group (n = 32), and the control group (n = 35) received the conventional nursing pre-discharge care. The data was collected using the Therapeutic Self-Care Scale (TSCS) in four dimensions: medications, symptoms, activities of daily living and health status management, applied before hospital discharge and one month after hospital discharge to both groups. Patients were recruited from an intensive cardiovascular care unit during 2016.

Results: The results showed statistically significant differences between both groups (p < 0.001). The intervention group tended to improve their self-care skills while the control group had opposite trends, self-care skills decreased.

Conclusions: According to the findings of the study, a systematized and structured educational program, is effective in developing self-care skills in patients after an acute coronary syndrome.


Self-care skills Educational program Acute coronary syndrome 


  1. 1.
    Grady, P.A., Gough, L.L.: Self-management: a comprehensive approach to management of chronic conditions. Am. J. Publ. Health 104(8), e25–e31 (2014). Scholar
  2. 2.
    WHO: Noncommunicable Diseases Progress Monitor, 2017. World Health Organization, Geneva. Licence: CC BY-NC-SA 3.0 IGO (2017)Google Scholar
  3. 3.
    Sidani, S.: Self-care. In: Doran, D.M. (ed.) Nursing Outcomes: The State of the Science, 2nd edn, pp. 79–130. Jones & Bartlett, Sudbury (2011)Google Scholar
  4. 4.
    Drakopoulou, M., Toutouzas, K., Tousoulis, D.: Chapter 2.5 – Acute coronary syndromes. In: Tousoulis, D. (ed.) Coronary Artery Disease, pp. 201–233. Academic Press (2018)Google Scholar
  5. 5.
    Chauvet-Gelinier, J.-C., Bonin, B.: Stress, anxiety and depression in heart disease patients: a major challenge for cardiac rehabilitation. Ann. Phys. Rehabil. Med. 60(1), 6–12 (2017). Scholar
  6. 6.
    Balady, G.J., et al.: Referral, enrollment, and delivery of cardiac rehabilitation/secondary prevention programs at clinical centers and beyond: a presidential advisory from the American Heart Association. Circulation 124(25), 2951–2960 (2011). Scholar
  7. 7.
    Piepoli, M.F., et al.: 2016 European Guidelines on cardiovascular disease prevention in clinical practice: the sixth joint task force of the European Society of cardiology and other societies on cardiovascular disease prevention in clinical practice (constituted by representatives of 10 societies and by invited experts) developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). Eur. Heart J. 37(29), 2315–2381 (2016). Scholar
  8. 8.
    World Health Organization: Needs and Action Priorities in Cardiac Rehabilitation and Secondary Prevention in Patients with Coronary Heart Disease. WHO Regional Office for Europe, Geneva (1993)Google Scholar
  9. 9.
    Magalhães, S., et al.: Efeitos a longo prazo de um programa de reabilitação cardíaca no controlo dos fatores de risco cardiovasculares. Rev. Port. Cardiol. 32(3), 191–199 (2013). Scholar
  10. 10.
    Foster, J.G., Lewis, S.F., Hennekens, C.H.: Editorial commentary: cardiac rehabilitation: major benefits and minor risks. Trends Cardiovasc. Med. 27(6), 426–427 (2017). Scholar
  11. 11.
    Bjarnason-Wehrens, B., et al.: Cardiac rehabilitation in Europe: results from the European cardiac rehabilitation inventory survey. Eur. J. Cardiovasc. Prev. Rehabil. 17(4), 410–418 (2010). Scholar
  12. 12.
    Coordenação Nacional para as Doenças Cardiovasculares, 2009. Reabilitação Cardíaca: Realidade Nacional e Recomendações Clínicas.
  13. 13.
    Chen, H.Y., et al.: Decade-long trends in 30-day rehospitalization rates after acute myocardial infarction. J. Am. Heart Assoc. 4(11), e002291 (2015). Scholar
  14. 14.
    Boisvert, S., Proulx-Belhumeur, A., Gonçalves, N., Doré, M., Francoeur, J., Gallani, M.C.: An integrative literature review on nursing interventions aimed at increasing self-care among heart failure patients. Revista Latino-Americana de Enfermagem 23(4), 753–768 (2015). Scholar
  15. 15.
    Adams, N.E.: Bloom’s taxonomy of cognitive learning objectives. J. Med. Libr. Assoc. JMLA 103(3), 152–153 (2015). Scholar
  16. 16.
    Rice, H., Say, R., Betihavas, V.: The effect of nurse-led education on hospitalisation, readmission, quality of life and cost in adults with heart failure: a systematic review. Patient Educ. Couns. 101(3), 363–374 (2018). Scholar
  17. 17.
    Sousa, M.R., Martins, T., Pereira, F.: O refletir das práticas dos enfermeiros na abordagem à pessoa com doença crónica. Revista de Enfermagem Referência 6, 55–63 (2015)CrossRefGoogle Scholar
  18. 18.
    Holman, H., Lorig, K.: Patient self-management: a key to effectiveness and efficiency in care of chronic disease. Public Health Rep. 119(3), 239–243 (2004). Scholar
  19. 19.
    Cardoso, A., Queiros, P., Ribeiro, C., Amaral, A.: Cultural adaptation and psychometric properties of the portuguese version of the therapeutic self-care scale. Int. J. Caring Sci. 7(2), 426 (2014)Google Scholar
  20. 20.
    Mampuya, W.M.: Cardiac rehabilitation past, present and future: an overview. Cardiovasc. Diagn. Ther. 2(1), 38–49 (2012). Scholar
  21. 21.
    Rocha, E., Nogueira, P.: As doenças cardiovasculares em Portugal e na região Mediterrânica: uma perspetiva epidemiológic. Revista Factores de Risco 36, 35–44 (2015)Google Scholar
  22. 22.
    Fernandes, A.: Avaliação da eficácia de um programa de intervenção psicológica breve em pacientes pós-síndrome coronária aguda. (PhD), Universidade do Minho, Braga (2012)Google Scholar
  23. 23.
    Abreu, A., et al.: Mandatory criteria for cardiac rehabilitation programs: 2018 guidelines from the Portuguese society of cardiology. Rev. Port. Cardiol. 37(5), 363–373 (2018). Scholar
  24. 24.
    Peters, A.E., Keeley, E.C.: Trends and predictors of participation in cardiac rehabilitation following acute myocardial infarction: data from the behavioral risk factor surveillance system. J. Am. Heart Assoc. 7(1) (2017).
  25. 25.
    Kadda, O., Marvaki, C., Panagiotakos, D.: The role of nursing education after a cardiac event. Health Sci. J. 6(4), 634 (2012)Google Scholar
  26. 26.
    de Melo Ghisi, G.L., da Silva Chaves, G.S., Britto, R.R., Oh, P.: Health literacy and coronary artery disease: a systematic review. Patient Educ. Couns. 101(2), 177–184 (2018). Scholar
  27. 27.
    Ades, P.A., et al.: Cardiac rehabilitation exercise and self care for chronic heart failure. JACC Heart Fail. 1(6), 540–547 (2013). Scholar
  28. 28.
    Dickson, V.V., Nocella, J., Yoon, H.-W., Hammer, M., Melkus, G.D., Chyun, D.: Cardiovascular disease self-care interventions. Nurs. Res. and Pract. 2013, Article ID 407608 (2013). Scholar
  29. 29.
    Megari, K.: Quality of life in chronic disease patients. Health Psychol. Res. 1(3), e27 (2013). Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Minho UniversityBragaPortugal
  2. 2.Évora UniversityÉvoraPortugal

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