Journal
INTERNATIONAL JOURNAL OF CARDIOLOGY
Volume 187, Issue -, Pages 693-699Publisher
ELSEVIER IRELAND LTD
DOI: 10.1016/j.ijcard.2015.03.336
Keywords
Acute coronary syndrome; Patient-centered care; Person-centred care; Randomised controlled trial; Self-efficacy; Cardiac rehabilitation
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Funding
- Centre for Person-Centred Care at the University of Gothenburg (GPCC), Sweden
- Swedish Government's grant for Strategic Research Areas, Care Sciences (Application to Swedish Research Council) [2009-1088]
- University of Gothenburg, Sweden
- Swedish Research Council [521-2013-2723]
- county councils concerning economic support for providing an infrastructure for research and education of doctors [ALFGBG-44681]
- Narhalsan Research and Development, Primary Health Care, RegionVastra Gotaland
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Aim: To evaluate if person-centred care can improve self-efficacy and facilitate return to work or prior activity level in patients after an event of acute coronary syndrome. Method: 199 patients with acute coronary syndrome <75 years were randomly assigned to person-centred care intervention or treatment as usual and followed for 6 months. In the intervention group a person-centred care process was added to treatment as usual, emphasising the patient as a partner in care. Care was co-created in collaboration between patients, physicians, registered nurses and other health care professionals and documented in a health plan. A team-based partnership across three health care levels included transparent knowledge about the disease and medical state to achieve agreed goals during recovery. Main outcome measure was a composite score of changes in general self-efficacy >= 5 units, return to work or prior activity level and re-hospitalisation or death. Results: The composite score showed that more patients (22.3%, n = 21) improved in the intervention group at 6 months compared to the control group (9.5%, n = 10) (odds ratio, 2.7; 95% confidence interval: 1.2-6.2; P = 0.015). The effect was driven by improved self-efficacy = 5 units in the intervention group. Overall general self-efficacy improved significantly more in the intervention group compared with the control group (P = 0.026). There was no difference between groups on re-hospitalisation or death, return to work or prior activity level. Conclusion: A person-centred care approach emphasising the partnership between patients and health care professionals throughout the care chain improves general self-efficacy without causing worsening clinical events. (C) 2015 Elsevier Ireland Ltd. All rights reserved.
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