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Can causal explanations about endothelial pathophysiology benefit patient education? A cluster randomized controlled
Karen M Zhang1, Peter L Prior2, Leora C Swartzman3
1Department of Psychology, University of Western Ontario, London, ON, N6G 2K3, Canada; Juravinski Cancer Centre, Hamilton Health Sciences, Hamilton, ON, L8V 5C2, Canada.
Insights
Explaining causal links improves patient understanding of cardiovascular disease management. This enhanced knowledge boosts confidence in cardiac rehabilitation and secondary prevention (CRSP) programs, leading to better self-management.
Area of Science:
- Cardiology
- Medical Education
- Health Psychology
Background:
- Cardiovascular disease (CVD) self-management requires deep patient understanding.
- Current patient education may not adequately explain causal links in CVD.
Purpose of the Study:
- To determine if explaining causal links (causal information) improves CVD self-management knowledge.
- To assess if causal information enhances patient perceptions of cardiac rehabilitation and secondary prevention (CRSP) programs.
Main Methods:
- 94 newly referred CRSP patients were cluster randomized to usual care (UC) or UC + causal information (UC+CI).
- Knowledge depth (factual vs. deep) was measured using a cognitive-reasoning task.
- Patient knowledge and program efficacy beliefs were assessed.
Main Results:
- Patients receiving UC+CI demonstrated deeper CVD management knowledge than UC patients, even after controlling for education.
- The UC+CI group showed higher factual knowledge and rated the CRSP program as more credible.
- Deep knowledge mediated the link between causal information and perceived program credibility.
Conclusions:
- Providing causal information enhances patients' understanding of CVD management.
- Causal information improves the perceived credibility and effectiveness of CRSP programs.
- This approach can improve patient education and engagement in CRSP.
Objective:
To examine whether explaining causal links among endothelial pathophysiology, cardiac risk factors, symptoms and health behaviors (termed causal information) enhances patients' depth of knowledge about cardiovascular disease self-management and their perceptions of the cardiac rehabilitation and secondary prevention (CRSP) program.
Methods:
Newly referred CRSP patients (N = 94) were cluster randomized to usual care (control; UC) or usual care with causal information (intervention; UC + CI). Depth of knowledge (factual vs. deep) was measured with an adapted cognitive-reasoning task. Patients' cardiovascular knowledge and beliefs about the efficacy of a CRSP program were assessed.
Results:
After controlling for education level, patients in UC + CI demonstrated deeper knowledge about cardiovascular management than did those in UC. The UC + CI group showed higher factual knowledge than their counterparts after covarying education, occupation status and BMI. The UC + CI group also rated the CRSP program as more credible than those in UC, after controlling for age. Deep knowledge mediated the relationship between group conditions and perceived credibility of CRSP.
Conclusion:
Causal information can enhance the depth of patients' understanding of cardiovascular disease management and perceived treatment credibility of the CRSP program.
Practice Implications:
Explaining causal links may help improve patient education delivery and enhance patient engagement in CRSP.
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