Effects of Home-Based Cardiac Rehabilitation Using Telenursing on Quality of Life and Treatment Adherence in Patients with Acute Coronary Syndromes

Effects of Rehabilitation on Quality of Life and Treatment Adherence in Patients with Acute Coronary Syndromes

A single-blind, parallel-group randomized clinical trial involving 78 patients.

The samples will be selected consecutively and based on the inclusion criteria among patients with acute coronary syndrome hospitalized in the cardiac care units and cardiology ward of Hajar teaching hospital of Shahrekord; then will be randomly allocated to the intervention and control groups.

Inclusion criteria: age 18-80 years, informed consent, confirmed diagnosis of acute coronary syndromes, ejection fraction≥20, ability to communicate in Persian, and having a mobile phone; Exclusion criteria: dysrhythmias and diseases preventing exercise, severe psycho-cognitive disorders, class IV of heart failure, and need for coronary artery bypass surgery

Intervention group: In the first stage, the necessary information for developing the rehabilitation program content for the participants will be collected. In the second stage, participants will undergo six 40-minute rehabilitation sessions. The sessions will be conducted weekly by a trained researcher and virtually through telephone calls and educational videos. The content of the rehabilitation sessions include 4 main areas of lifestyle changes (including management of dietary and medication regimen, comorbidities, and physical activity), control of signs and symptoms, care after invasive coronary procedures and psychological support. In this group, an educational brochure will also be provided to participants at the beginning of the sessions. Patients in the control group will receive only the routine care and education provided before the study.

Quality of Life, Adherence to Treatment

Eligible participants in this study will be allocated to two intervention and control groups with a ratio of 1.1 using random allocation. To generate the random allocation sequence, an independent researcher not involved in conducting of the study will use the website https://www.random.org/. For this purpose, a random sequence including 78 letters (A: intervention and B: control) will be generated. To conceal the generated allocation sequence, each of the A or B codes of the generated sequence will be separately placed in opaque and sealed envelopes and the envelopes will be numbered consecutively from 1 to 78. After selecting eligible participants and obtaining informed consent, the envelopes will be opened in numerical order by the ward nurses who have no role in the study process, and individuals will be assigned to the intervention or control group based on the letter contained in the envelope.

Considering the nature of the intervention, the participants, the principal researcher and the researchers who are responsible for implementing the intervention, collecting data and assessing outcomes, will not be blinded to the allocation of individuals to the study groups. The ward nurses will only assist in opening the allocation envelopes and have no role in the other stages of the study. On the other hand, the data analyst will be blinded to the allocation of the participants in the study.