الفهرس | Only 14 pages are availabe for public view |
Abstract Coronary artery disease is one of most dangerous threats to human health due to its high incidence and mortality rates. CAD is a term given to heart problems caused by narrowing or blockage of the coronary arteries which is usually caused by atherosclerosis. There are many risk factors that increase the probability to develop the disease, some of them can be modified but others are not. Unhealthy diet, lack of physical activity, smoking, overweight or obesity, and emotional stress, as well as high blood pressure, high blood sugar, and high blood cholesterol levels are considered modifiable risk factors can be. On the other hand, the non- modifiable risk factors can be age, gender, family history, and race. The management of coronary artery disease may be medical, surgical or a combination of both depending on the severity of clinical presentation of the disease, in addition to modifications of unhealthy life style which include following a healthy dietary plan, smoking cessation, optimizing body weight, undertaking regular exercise program, controlling high blood pressure and high blood glucose level, and following stress reduction techniques, as well as regular follow up in order to improve quality of life. The nurse has a significant role in assisting patients to deal with their disease through health teaching about important information regarding the nature of disease process and treatment modalities, in addition to assessing their lifestyle and then modification of their unhealthy behaviors regarding CAD. The present study aimed to Assess health related knowledge and behaviors among patients with coronary artery disease. Materials and Method Materials Research design: A descriptive research design was utilized to accomplish the aim of the present study. Setting The study was conducted in the OutpatientC clinic of Damanhur Medical National Institute (DMNI), at Beheira governorate. Subjects: A convenient sample consisted of 90 adult patients with coronary artery disease admitted to the above mentioned setting were included in the study who met the following criteria: - Adult patients of both genders, age ranging from 20 to 60 years old. - Has coronary artery disease for at least 6 months and more. - Patients who are conscious and able to communicate effectively. - Patients willing to participate in the study. - Free from associated illness including malignancies, rheumatoid -arthritis, and hypertensive crisis. Tools of the study: Two tools were used to collect the required necessary data in the present study: Tool one: Health Related Knowledge Among Patients With Coronary Artery Disease Structured Interview Schedule which included two parts, assessed patients’ socio-demographic characteristics and clinical data, as well as patients’ knowledge related to nature of coronary artery disease. Tool two: Health Related Behaviors Among Patients With Coronary Artery Disease (HRBs-CAD) Structured Interview Schedule to assess health related behaviors among patients with coronary artery disease related to six parameters including related to diet habits, compliance with therapeutic drugs, physical activity, smoking habits, and stress management follow up. Methods: The study tools were developed by the researcher after reviewing of recent relevant literature. The content of constructed tools was revised by a jury of 5 experts in the field of Medical Surgical Nursing Department of the Faculty of Nursing at Alexandria University and Faculty of Nursing at Damanhur University to test content validity, completeness, and clarity of items. Comments and suggestions of jury were considered and the tools were modified accordingly. A pilot study was conducted on 10% (9 patients) of the study sample to ascertain the applicability, clarity and feasibility of the developed tools. Reliability of tools was identified using Cronbach’s Alpha statistical test. The reliability coefficient value was 0.768 for tool one part two and 0.706 for tool two, in which both are acceptable. Data collection: After securing the administrative approval, the data collection was started and continued for a period of four months from September 2021to December 2021. A convenient sample consisted of 90 adult patients with coronary artery disease who met the inclusion criteria of the subjects were recruited from outpatient cardiac clinic of Damanhur Medical National Institute (DMNI). Every patient was interviewed individually once by the researcher to collect the needed data of patients knowledge, and health related behaviors adopted by patients using the developed tools. Data was collected before or after meeting the patient with the physician, in morning shift at the waiting area of the clinic, each interview lasted about 30-45 minutes. The main results of this study: The present study showed that more than half of the studied patients (52.2%) were in the age group of 50- ˂ 60 years, about two thirds (66.7%) of the studied patients were males, the highest percentage (86.7%) of the studied patients was married, secondary educated patients formed the half (50%) of the studied patients, and manual workers represented the highest percent (36.7%). The present study found that, about two thirds (66.3%) of the studied patients work between six to ten hours per day, the majority (38.8%) of the nature of their work was mental & muscular activities, and about two thirds (67.5%) of the studied patients, their disease condition had an impact on their work. More than half (57.8%) of the studied patients were living in rural areas, and more than half (60%) of the studied patients reported that, their monthly income was insufficient to fulfill the daily requirements. The present study revealed that chest pain, discomfort in shoulders, arms, neck, jaw, or back, dyspnea, and heartburn were the most common signs and symptoms reported by the studied patients with (100%, 84.4%, 78.9%, 45.6% respectively). The present study revealed that More than half (54.4%) of the studied patients had bad knowledge level, while 45.6% had fair knowledge level. The present study illustrated that the majority of the studied patients had fair health behaviors related to diet habits, compliance with therapeutic drugs, and stress management (68.9%, 53.3%, and 86.7% respectively). While The majority of the studied patients had negative health behaviors related to physical activity, smoking habits, and follow up(72.2%, 90%, 57.8% respectively). More than half (60%) of the studied patients had negative level of overall health related behaviors. The current results showed that statistically significant positive correlation was found between patients’ knowledge level and age, gender, level of education, occupation, area of residence, and monthly income (p = 0.026, p=<0.001, p=<0.001, p = <0.001, p = 0.001, p =<0.001 respectively). The current results also showed that statistically significant positive correlation was found patients’ health-related behavior level and age, gender, level of education, occupation, and monthly income (p = 0.017, p = <0.001, p = <0.001, p = 0.001, p = 0.004 respectively). The present study showed that a statistically significant positive correlation was found between overall knowledge level and overall health related behavior scores of the studied patients with coronary artery disease (p =0.001). Conclusion Based on the study findings, it can be concluded that the majority of the studied patients had bad knowledge level related to nature of coronary artery disease. Moreover, it can be concluded that the majority of the studied patients had negative level of overall health related behaviors regarding CAD. Recommendations The following were the main recommendations based on the findings of the present study: Recommendations for patients: Development and application of educational sessions for patients to improve their knowledge about the nature of coronary artery disease. Illustrated booklets, handouts, and audiovisual materials should be provided for teaching patients and their families’ healthy behaviors regarding coronary artery disease. Recommendations for nurses: Nurses should receive updated educational sessions about health-related behaviors regarding coronary artery disease. Periodic scientific meetings among physicians, nurses, and families must be conducted to discuss patient’s problems and establish a comprehensive plan for CAD patients’ needs. Recommendations for future studies: Evaluate effect of nursing interventions on health practices’ modifications among patients with coronary artery disease. Assessment of factors affecting CAD patient’s compliance with therapeutic regimen. |