Association Between Mind Mapping Combined with Teach-Back and Follow-Up Adherence After Percutaneous Coronary
Xiaofang Wang1, Jia Wei1, Yanni Wu1
1Department of Cardiovascular Medicine, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, People's Republic of China.
Background:
Suboptimal follow-up adherence after percutaneous coronary intervention (PCI) compromises secondary prevention and elevates the risk of major adverse cardiovascular events (MACEs). Conventional health education is often insufficient, necessitating a structured, practical, and evidence-based nursing protocol.
Objective:
To identify factors influencing post-PCI follow-up adherence and assess the association between a mind mapping combined with teach-back educational intervention and levels of adherence and MACEs.
Methods:
This single-center retrospective study analyzed data from a real-world nursing quality improvement initiative, including patients undergoing PCI during January, 2024-November, 2024. Patients were divided into mind mapping + teach-back or routine education group. Propensity score matching was employed to balance baseline characteristics. Follow-up adherence (≥ 3 complete visits) and 12-month MACE incidence were compared. Multivariable logistic regression was used to identify adherence factors. Kaplan-Meier and Log rank tests were utilized to compare MACE-free survival.
Results:
After matching (63 patients per group), baseline characteristics were balanced. High follow-up adherence was observed more frequently in the mind mapping + teach-back group (79.4% vs. 61.9%, P = 0.031). The combined intervention was independently associated with higher adherence (OR = 2.658, 95% CI: 1.042-6.783, P = 0.041). The mind mapping + teach-back group showed a lower observed 12-month MACE incidence (11.1% vs. 20.6%, P = 0.048) and a higher MACE-free survival rate (log-rank P = 0.042).
Conclusion:
In this exploratory study, the mind mapping combined with teach-back method was associated with better follow-up adherence; a lower incidence of MACE was also observed, although this finding is exploratory given the limited sample size and event numbers. It may represent a promising and operable nursing practice tool. These findings suggest a potential benefit that warrants further investigation; our results provide preliminary evidence to inform the design of future prospective randomized controlled trials, rather than immediate integration into clinical practice.
