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Collaborative couple-based management using King's theory improves health behaviours after percutaneous coronary
Qiaohong Yang1, Hualong Ma1, Jingjuan Huang2
1School of Nursing, Jinan University, No. 601 Huangpu Avenue West, Tianhe District, Guangzhou, Guangdong Province 510632, P.R. China.
Insights
Couple-focused case management improved health outcomes for patients after percutaneous coronary intervention (PCI). This intervention enhanced self-efficacy and adherence to lifestyle changes, benefiting coronary heart disease (CHD) patients.
Area of Science:
- Cardiovascular Health
- Health Management
- Nursing Theory
Background:
- Coronary heart disease (CHD) management post-percutaneous coronary intervention (PCI) requires effective patient and spousal support.
- KING's Goal Attainment Theory provides a framework for collaborative patient-spouse health management.
Purpose of the Study:
- To evaluate the impact of a couple-focused case management intervention, based on KING's Goal Attainment Theory, on health outcomes for post-PCI patients with CHD.
- To assess improvements in self-efficacy, adherence to lifestyle modifications, and lipid profiles.
Main Methods:
- A randomized controlled trial (RCT) involving 194 post-PCI patients with CHD.
- Intervention group received KING's Theory-based couple-focused case management alongside routine care.
- Control group received routine care only. Outcomes measured at baseline, 1 month, and 3 months post-discharge.
Main Results:
- The intervention significantly improved chronic disease management self-efficacy, medication adherence, healthy diet adherence, and exercise adherence (p < .05).
- Associated improvements were observed in total cholesterol, triglycerides, and low-density lipoprotein levels (p < .05).
- No significant differences were found in high-density lipoprotein levels, revascularization rates, recurrent angina, in-stent restenosis, or left ventricular ejection fraction.
Conclusions:
- Collaborative couple-focused management based on KING's Goal Attainment Theory enhances self-efficacy and lifestyle adherence in post-PCI CHD patients.
- The intervention positively impacts lipid profiles, suggesting a beneficial role in CHD management.
- Further research on cost-effectiveness and long-term effects is warranted.
Aims:
To explore the impact of a collaborative management for couples based on KING's Goal Attainment Theory on the health outcomes of post-percutaneous coronary intervention (PCI) patients with coronary heart disease (CHD).
Methods And Results:
This RCT involved 194 eligible patients, randomly assigned to either a control group (CG) or an intervention group (IG). The CG received routine care and follow-up, while the IG received KING's Theory-based couple-focused case management in addition to routine care. The intervention comprised pre- and post-discharge sessions, containing dyadic goal-setting and dyadic health management strategies, fostering collaborative decision-making between the patient and their spouse. Outcomes were measured at T0 (2 days post-stabilisation), 1 and 3 months post-discharge. The mean age of the participants was 61.3 (SD = 12.0) years. Baseline data were similar in both groups. The intervention significantly improved chronic disease management self-efficacy (β = 1.175), medication adherence (β = 0.834), healthy diet adherence (β = 1.127), exercise adherence (β = 1.206), and was associated with the improvements of total cholesterol (β = -0.293), triglycerides (β = -0.280), and low-density lipoprotein (β = -0.229). All P < 0.05. However, the difference in high-density lipoprotein levels (β = -0.012), the rate of revascularization, recurrent angina pectoris, in-stent restenosis, and left ventricular ejection fraction (Z = -0.667) between the groups was not significant, all P > 0.05.
Conclusion:
The collaborative management for couples based on KING's Goal Attainment Theory significantly improved self-efficacy and adherence to lifestyle changes of post-PCI patients with CHD, and was associated with the improvements of the lipid profiles. Future studies could investigate the cost-effectiveness and long-term impact of this theory-based intervention.
Registration:
Chinese Clinical Trial Registry (ChiCTR): ChiCTR2400085183.
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