Cardiac Nurses' Self-Rated Confidence and Knowledge in Patient Education: A Mixed-Methods Study

Phase I cardiac rehabilitation (CR) focuses on patient education for self-management post-discharge; however, it is often underdelivered, impacting subsequent uptake of phase II CR. This study aimed to explore the self-rated knowledge and confidence of cardiac nurses for inpatient education, specifically phase I (CR).

A mixed-methods design was undertaken, integrating a cross-sectional survey with concurrent qualitative interviews with cardiac nurses. Descriptive statistics and sub-group analysis were used to evaluate cardiac nurses' experience and training, patient education practices, self-rated knowledge and confidence levels on delivering the "Six Steps to Cardiac Recovery" resource and barriers to education delivery. Thematic analysis was used to analyse qualitative data to identify key educational needs and barriers.

Forty-three (43) nurses fully completed the survey. Overall, nurses had high levels of self-rated knowledge and confidence. Of the "Six Steps to Cardiac Recovery", those with the lowest knowledge and confidence were: 1) exercise and activity, 2) emphasising the importance of CR and 3) explaining the diagnosis/procedure. The study found that years of nursing experience influenced self-rated knowledge and confidence in delivering patient education. From 10 interviews, six main themes were identified (with 13 sub-themes) related to education processes, culture, barriers and resource gaps. Time constraints and competing clinical demands were the main barriers to patient education.

Despite overall high self-rated knowledge and confidence among nurses, there are three areas where knowledge and confidence can be improved. These findings can assist in designing a tailored nursing education program, a strategy aimed to enhance patient education practices, ultimately improving secondary prevention of cardiovascular diseases.