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Evaluation of knowledge, perceived control, symptoms of anxiety and depression related to a model for follow-up in adults with congenitally malformed hearts: a randomised control trial
Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Medical and Health Sciences, Cardiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Centre, Department of Cardiology UHL.
Linköping University, Department of Medical and Health Sciences, Cardiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Centre, Department of Cardiology UHL.ORCID iD: 0000-0002-2608-2062
Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Centre, Department of Cardiology UHL.ORCID iD: 0000-0002-4259-3671
2011 (English)Manuscript (preprint) (Other academic)
Abstract [en]

Objective: To evaluate the effects of a model including computer-based and individualised education and psychosocial support for adults with congenitally malformed hearts.

Design: Prospective randomised controlled multicentre trial.

Setting: Four hospital outpatient clinics in Sweden.

Participants: Adults with congenitally malformed hearts.

Interventions: Comparing usual care twith education and psychosocial support by a multidisciplinary team.

Main Outcome Measures: Knowledge and perceived control regarding the heart condition, and symptoms of anxiety and depression at baseline, 3 and 12-months follow-up.

Results: Out of 114 included participants, 58 were randomised to the control group, and 56 to the intervention group. The average age was 34 (SD 13.5) years. Results showed a significant between-group treatment effect in general knowledge after 3 months (effect size 0.63, p=<0.01), and 12-month (effect size 0.53, p= 0.02). Knowledge regarding endocarditis also increased significantly between-group after 3 months (effect size 0.87, p= <0.01), and over time between baseline and 3 months (effect size 1.43, p=<0.001), and between baseline and 12-months (effect size 0.58, p= 0.02). There were no changes in knowledge in domains regarding self-management of medical treatment and contraceptives and pregnancy in any of the groups. Further, the intervention did neither increase nor decrease the perceived control over the heart condition or symptoms of anxiety and depression.

Conclusion: Education and psychosocial support by a multidisciplinary team was effective in improving and maintaining knowledge about self-management in adults with heart malformation. Future research is needed to determine the long-time effects on selfmanagement behaviours and perceived control.

Place, publisher, year, edition, pages
2011. Vol. 83, no 2, 247-51 p.
Keyword [en]
Congenital heart disease, hospital outpatient clinic, follow-up studies, computer program, patient education
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-68676OAI: oai:DiVA.org:liu-68676DiVA: diva2:419578
Available from: 2011-05-27 Created: 2011-05-27 Last updated: 2013-09-11Bibliographically approved
In thesis
1. Follow-up of adults with congenitally malformed hearts with focus on individualised and computer-based education and psychosocial support: A descriptive and interventional study
Open this publication in new window or tab >>Follow-up of adults with congenitally malformed hearts with focus on individualised and computer-based education and psychosocial support: A descriptive and interventional study
2011 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background and aims: Many adults with congenitally malformed hearts are at risk for complications such as decreased function and capacity of the heart due to the heart defect and previously surgery. This advocates self-management behaviours related to medical treatments, physical activity, preventions of endocarditis, some restrictions regarding suitable employment and spare time activities, birth control and pregnancy, but also lifestyle concerns such as refraining from smoking and healthy eating. Sufficient knowledge and support are requirements for successful self-management. The overall aim of this thesis was to describe educational needs, develop a tool for assessing knowledge and to evaluate the effects of a follow-up model providing education and psychosocial support to adults with congenitally malformed hearts.

Subjects and methods: Adults (≥18 years of age) with the ten most common heart defects namely ventricular septal defect, atrial septal defect, coarctation of the aortae, aortic valve stenosis (defined as uncomplicated heart defects) and tetralogy of Fallot, complete transposition of the great arteries, congenitally corrected transposition of the great arteries, Ebstein anomaly and Eisenmenger syndrome (defined as complicated heart defects) were included in the studies. To apprehend the educational needs (I), sixteen adults with heart malformations, ranging from 19-55 years of age, were interviewed and data were analysed qualitatively using phenomenographic method. As a tool to evaluate knowledge, an instrument named Knowledge scale for adults with Congenital Malformed Hearts (KnoCoMH) was developed and psychometrically evaluated (II) in 19 + 114 adults with the ten most common heart defects average age 34 ± 13.5. A model for follow-up was described and initially evaluated (III) by 55 adults with the most common heart defects and finally tested in a randomised controlled trial (IV) with a total of 114 adults with congenitally malformed hearts (56 participants in intervention group and 58 in control group with average age 34 ± 13.5). The intervention group recived a model for follow-up with individualise and computer-based eduction and psychosocial support by a multidisciplinary team.

Results: Two-way communication when given information was found to be crucial in order to enhance knowledge (I). Knowledge was seen as a tool for managing important areas in life. The KnoCoMH (II) was found to be a valid and reliable scale and can now be used to estimate knowledge in adults with congenitally malformed hearts. The model for follow-up (III) was effective in improving and maintaining knowledge (IV) about self-management in adults with heart malformation.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2011. 109 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1239
Keyword
Congenital heart disease, education, information, instrument development, multidisciplinary team, nursing, phenomenography, psychometrics
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-68677 (URN)978-91-7393-189-2 (ISBN)
Public defence
2011-06-01, Berzeliussalen, Campus US, Linköpings universitet, Linköping, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2011-05-27 Created: 2011-05-27 Last updated: 2013-09-11Bibliographically approved

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Rönning, HelénNielsen, Niels ErikSwahn, EvaStrömberg, Anna

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