RESUMO
AIMS: To test an educational programme with telephone follow-up to improve self-care in Brazilian patients who underwent percutaneous coronary intervention. BACKGROUND: Percutaneous coronary intervention has been established as a treatment for coronary disease. However, additional intervention is needed to improve self-care for individuals who undergo this procedure to reduce further disease. Telephone follow-up is one strategy that has been used to improve chronic disease self-care. DESIGN: Randomized controlled trial. TRIAL REGISTRATION: ClinicalTrials.gov, NCT01341093. METHODS: Sixty patients who were preparing for their first percutaneous coronary intervention between 2011-2012 were randomly allocated to an educational programme with telephone follow-up (N = 30) or a control group (N = 30). Perceived health status was assessed with the Medical Outcomes Study 36-Item Short Form. Self-efficacy, symptoms of anxiety and depression and medication adherence were also assessed. Measures were collected before intervention (baseline) and 6 months later. RESULTS: Both groups improved from baseline to 6 months in the 'Physical Component Summary' and in the domains of 'Physical Functioning', 'Role-Emotional' and 'Role-Physical'. The educational programme group showed a reduction in anxiety from baseline to 6-month follow-up, while the control group showed a slight increase. No differences in symptoms in depression and self-efficacy were found and both groups reported high levels of medication adherence. CONCLUSION: The educational programme with telephone follow-up is a promising intervention as it led to reduction in anxiety for those receiving the educational programme. Further improvements in timing and focus of the educational programme, such as targeting emotional and social lifestyle changes, might be warranted.
Assuntos
Doença das Coronárias/enfermagem , Educação de Pacientes como Assunto , Intervenção Coronária Percutânea/enfermagem , Autocuidado/métodos , Adulto , Idoso , Brasil , Doença Crônica , Doença das Coronárias/cirurgia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Avaliação de Programas e Projetos de Saúde , Fatores Socioeconômicos , TelefoneRESUMO
OBJECTIVE: To identify studies of telephone follow-up conducted with patients who had undergone myocardial revascularization, and to assess and synthesize the results. DESIGN AND METHODS: This is a systematic review; the literature search was conducted in six electronic databases. Controlled descriptors were health education, teaching, myocardial revascularization, coronary artery bypass, angioplasty, telenursing, telephone, and hotlines; the noncontrolled descriptor was needs information. Of 170 identified studies, seven met the inclusion criteria and were selected for analysis. The Jadad scale, which ranges from 0 to 5, was used to assess the methodological quality of studies, with scores of 3 to 5 indicative of higher quality. FINDINGS: Five of the seven studies found statistically significant positive changes in the outcome measures of health-related quality of life, pain, physical functioning, mood symptoms, anxiety, knowledge about self-care measures, medication compliance, and the lipid profile. Four of these five studies had a Jadad score of 3 and were of higher quality. CONCLUSIONS: This review provides nurses and other clinicians with a synthesis of research on telephone follow-up in patients after myocardial revascularization. Of the seven studies analyzed, five showed evidence of some benefit from telephone follow-up. Their findings support the use of telephone follow-up to periodically assess patient knowledge, discuss patient concerns and offer ways to address them, monitor mood symptoms and anxiety levels, and encourage behavioral and lifestyle changes. Although any telephone follow-up intervention must be adapted according to each patient's needs, the lack of similarity among and specific information about the interventions described in the analyzed studies made it difficult to evaluate specific elements. More research is needed to identify optimal content and frequency, number, and duration of calls.