Iranian Red Crescent Medical Journal (IRCMJ)

Current Issue

By Issue

By Author

By Subject

Author Index

Keyword Index

About Journal

Aims and Scope

Editorial Board

Publication Ethics

Indexing and Abstracting

Related Links

FAQ

Peer Review Process

Journal Metrics

News

Author Guidelines

Article Processing Charge

Effectiveness of an Educational Program through Mobile Health Application on Knowledge and Adherence to a Healthy Lifestyle in Cardiac Syndrome X Patients

Document Type : Research articles

Authors

1 Department of Nursing Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia Tehran Heart Center Hospital, Tehran University of Medical Science, Tehran, Iran

2 Department of Nursing Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia

3 Tehran Heart Center Hospital, Tehran University of Medical Science, Tehran, Iran

Abstract

Background: Cardiac syndrome X (CSX) is a form of ischemic heart disease with functional coronary microvascular abnormalities. The symptoms are often debilitating and sufferers have a poor quality of life, with costly demand for healthcare services. Therefore, an educational intervention contributes to the increase of knowledge about CSX risk factors and adherence to a healthy lifestyle.
Objectives: This study aimed to investigate the effectiveness of educational interventions on knowledge and adherence to a healthy lifestyle in CSX Patients.
Methods: A simple, two-arm, parallel, randomized control trial was conducted in the Heart Clinic on 100 CSX outpatients who were selected through randomized sampling and divided into experimental (n=50) and control (n=50) groups. This study assessed an educational program that has been provided through the Mobile Health application (mHealth app) to the experimental group. The data were collected using the Heart Disease Fact Questionnaire (HDFQ) and Adherence to a Healthy lifestyle questionnaire (AHLQ).
Results: In the intervention group, the difference between the pre-test and post-test mean scores of knowledge on CSX risk factors was statistically significant (SD=1.77; P<0.05). However, there was no significant difference between pre-test and post-test means scores in the control group (SD=3.12; P>0.05).
Conclusion: Patients with CSX have high morbidity and health care expenditure; therefore, the provision of an educational program through the mHealth app as well as lifestyle modification can be considered a highly effective and low-cost intervention contributing to an increase of knowledge about CSX risk factors in patients and adoption of a healthy lifestyle.

Keywords

References
  1. Masoudkabir F, Vasheghani-Farahani A, Hakki E, Poorhosseini H, Sadeghian S, Abbasi H, et al. Novel scoring system for prediction of cardiac syndrome x in women with typical angina and a positive exercise tolerance test. Tex Heart Inst J. 2018;45(1): 5–10. doi: 10.14503/THIJ-16-5906. [PubMed: 29556144].
  2. Vasheghani-Farahani A, Nouri N, Seifirad S, Sheikh Fathollahi M, Hakki E, Alidoost M, et al. Comparison of cardiovascular risk factors and biochemical profile in patients with cardiac syndrome X and obstructive coronary artery disease: A propensity score-matched study. ARYA Atheroscler . 213;9(5),269-73. [PubMed: 24302934].
  3. Saadat M, Masoudkabir F, Afarideh M, Ghodsi S, Vasheghani-Farahani A. discrimination between obstructive coronary artery disease and cardiac syndrome X in women with typical angina and positive exercise test; utility of cardiovascular risk calculators. Medicine (Kaunas). 2019;55(1):1-11. doi: 10.3390/medicina55010012. [PubMed: 30646563].
  4. Radico F, Cicchitti V, Zimarin, M, De Caterina R. Angina Pectoris and Myocardial Ischemia in the Absence of Obstructive Coronary Artery Disease: Practical Considerations for Diagnostic Tests. JACC Cardiovasc Interv. 2014;7(5):453-63. doi: 10.1016/j.jcin.2014.01.157. [PubMed: 28259226].
  5. Roffi M, Mukherjee D. Treatment-risk paradox in acute coronary syndromes. Eur Heart J. 2018;39(42):3807-09. doi: 10.1093/eurheartj/ehy577. [PubMed: 30247536].
  6. Soleimani A, Pourmoghaddas A, Sadeghi M, Roohafza H, Talaei M, Dianatkhah M, et al. Risk and age of cardiovascular event in women with metabolic syndrome: menopause age in focus. Metab Syndr Relat Disord. 2018;16(3):127-34. doi: 10.1089/met.2017.0096. [PubMed: 29437523].
  7. Kuruvilla S, Kramer CM. Coronary microvascular dysfunction in women: An overview of diagnostic strategies. Expert Rev Cardiovasc Ther. 2013;11(11):1515–25. Doi: 10.1586/14779072.2013.833854. [PubMed: 24160578].
  8. Patel H, Aggarwal N, Rao A, Bryant E, Sanghani R, Byrnes M, et al. Microvascular disease and small-vessel disease: the nexus of multiple diseases of women. J Women Health (Larchmt). 2020;29(6):770–9. doi: 10.1089/jwh.2019.7826. [PubMed: 32074468].
  9. WHO. Noncommunicable diseases (NCD) country profiles, cardiovascular diseases (CVDs).2014. Retrieved from http://www.who.int/mediacenter/factsheets/fs317/ e
  10. American Heart Association and American Stroke Association. (2019) Patient Education Resources for Healthcare Professionals. Red Dress DHHS, Go Red AHA; National Wear Red Day is a registered trademark.
  11. Nowbar NA, Gitto M, Howard PJ, Francis PD, Al-Lamee R. Mortality from ischemic heart disease. Circ Cardiovasc Qual Outcomes. 2019;12(6):1-11. doi: 10.1161/CIRCOUTCOMES.118.005375. [PubMed: 31163980].
  12. Najafipour H, Afshari M, Rostamzadeh F. Prevalence of Multiple Coronary Artery Disease Risk Factors in Kerman: A Population-Based Study in Southeast Iran. Iran J Med Sci. 2018;43(2):140–9. [PubMed: 29749982].
  13. Centers for Disease Control and Prevention. Underlying Cause of Death, 1999–2018. CDC WONDER Online Database. Atlanta, GA: Centers for Disease Control and Prevention.
  14. WHO. Noncommunicable diseases (ncd) country profiles, (2014). cardiovascular diseases (cvds). Retrieved from http://www.who.int/mediacenter/factsheets/fs317/ en/
  15. Abbott LS, Slate EH, Graven LJ. Cardiovascular disease risk among rural residents living with diabetes and prediabetes: a cluster randomized trial. Public Health Nurs. 2020;37(1):16-24. doi: 10.1111/phn.12659. [PubMed: 31489717]
  16. Anchah L, Hassali AM, Han Lim SM, Mohamed Ibrahim MI, Hian Sim K, Ong KT. Health related quality of life assessment in acute coronary syndrome patients: the effectiveness of early phase I cardiac rehabilitation. Health Qual Life Outcomes. 2017;15(1):1-14. doi: 10.1186/s12955-016-0583-7. [PubMed: 28086784].
  17. Zsilinszka R, Mentz RJ, DeVore AD, Eapen ZJ, Pang PS, Hernandez AF. Acute heart failure: alternatives to hospitalization. JACC Heart Fail. 2017;5(5):329-6. doi: 10.1016/j.jchf.2016.12.014. [PubMed: 28285117].
  18. Sestito A, Lanza GA, Monaco AD, Lamendola P, Careri G, Tarzia P, et al. Relation between cardiovascular risk factors and coronary microvascular dysfunction in cardiac syndrome X. J Cardiovasc Med. 2011;12(5):322-7. doi: 10.2459/JCM.0b013e3283406479. [PubMed: 2113558].
  19. Uribe-Heredia G, Arroyo-Espliguero R, Viana-Llamas MC, Piccone-Saponara LG, Álvaro-Fernandez H, Garcia-Magallon B. Type 2 diabetes mellitus, glycated haemoglobin levels, and cardiopulmonary exercise capacity in patients with ischemic heart disease. J Cardiopulm Rehabil Prev. 2020;40(3):167-73. doi: 10.1097/HCR.0000000000000451. [PubMed: 31714395].
  20. Sunamura M, Hoeve TN, van den Berg-Emons RJG, Boersma E, van Domburg RT, Geleijnse ML. Cardiac rehabilitation in patients with acute coronary syndrome with primary percutaneous coronary intervention is associated with improved 10-year survival. Eur Heart J Qual Care Clin Outcomes. 2018;4(3):168-72. doi: 10.1093/ehjqcco/qcy001. [PubMed: 29325067].
  21. Ezhumalai B, Ananthakrishnapillai A, Selvaraj RJ, Satheesh S, Jayaraman B. Cardiac syndrome X: clinical characteristics revisited. Indian Heart J. 2015;67(4):328-31. doi: 10.1016/j.ihj.2015.04.022. [PubMed: 26304564].
  22. Agrawal S, Mehta PK, Bairey Merz CN. Cardiac Syndrome X: Updat. Heart Fail Clin. 2016;12(1):141-56. doi: 10.1016/j.hfc.2015.08.012. [PubMed: 26567981].
  23. Lee YM, Bum Kim R, Lee HJ, Kim K, Shin MH, Hyeung-Keun P, et al. Relationships among medication adherence, lifestyle modification, and heart disease fact questionnaire in patients with acute myocardial infarction: a cross-sectional study. Health Qual Life Outcomes. 2018;16(1):1-8. doi: 10.1186/s12955-018-0921-z. [PubMed: 29788961].
  24. Lv J, Yu C, Guo Y, Bian Z, Yang L, Chen Y, et al. Adherence to healthy lifestyle and cardiovascular diseases in the chinese population. J Am Coll Cardiol. 2017;69(9):1116-25. doi: 10.1016/j.jacc.2016.11.076. [PubMed: 28254173].
  25. Szot W, Zając J, Kostkiewicz M, Kolarzyk E. Dietary patterns seem to influence the development of perfusion changes in cardiac syndrome X patients. Adv Clin Exp Med. 2015;24(3):453-62. doi: 10.17219/acem/34475. [PubMed: 26467134].
  26. International Telecommunication Union. Key Information and communications technology (ICT) indicators for developed and developing countries and the world. 2018. Retrieved from https://www.itu. int/en/ITU-D/Statistics/Pages/stat/default.aspx.
  27. Coorey GM, Neubeck L, Mulley J, Redfern J. Effectiveness, acceptability and usefulness of mobile applications for cardiovascular disease self-management: Systematic review with meta-synthesis of quantitative and qualitative data. Eur J Prev Cardiol. 2018;25(5):505–21. doi: 10.1177/2047487317750913. [PubMed: 29313363].
  28. Thakkar J, Kurup R, Laba TL, Santo K, Thiagalingam A, Rodgers A, et al. Mobile telephone text messaging for medication adherence in chronic disease: a meta-analysis. JAMA Intern Med. 2015;176(3):340–9. doi: 10.1001/jamainternmed.2015.7667. [PubMed: 26831740].
  29. Tang YH, Chong CH, Chua YP, Chui LP, Tang LY, Rahmat N. The effect of mobile messaging apps on cardiac patient knowledge of coronary artery disease risk factors and adherence to a healthy lifestyle. J Clin Nurs. 2018;27(23-24):4311-20. doi: 10.1111/jocn.1453. [PubMed: 29777560].
  30. Wagner J, Lacey K, Chyun D, Abbott G. Development of a questionnaire to measure heart disease risk knowledge in people with diabetes: the heart disease fact questionnaire. Patient Educ Couns. 2005;58(1):82-7. doi: 10.1016/j.pec.2004.07.004. [PubMed: 15950840].
  31. Sanofi Aventis, Adherence to a Healthy Lifestyle Questionnaire (AHLQ). Mapi Research. 2006. It complies with W3C WCAG 2.0. The 4M job code is SAGLB.SA.17.03.0183. Last update: December 2021
  32. WHO. Process of translation and adaptation of instruments.2016 from http://www.who.int/substance_abuse/research_tools/translation/en/
  33. Arnett KD, Blumenthal SR, Albert AM, Buroker BA, Goldberger ZD, Hahn EJ, et al. 2019 ACC/AHA guideline on the primary prevention of cardiovascular disease: a report of the american college of cardiology/american heart association task force on clinical practice guidelines. J Am Coll Cardiol. 2019;74(10):177-232. doi: 10.1016/j.jacc.2019.03.010. [PubMed: 30894318].
  34. Klimis H, Thakkar J, Chow G. Breaking Barriers: Text messages for primary prevention of cardiovascular disease: TextMe2 randomised controlled trial protocol. BMJ Open. 2020;34(7):905-13. doi: 10.1136/bmjopen-2020-036767. [PubMed: 32341047].
  35. Khonsari S, Chandler C Parker R, Holloway A. Increasing cardiovascular medication adherence: A medical research council complex mhealth intervention mixed-methods feasibility study to inform global practice. J Adv Nurs. 2020;76(10):2670-84. doi: 10.1111/jan.14465. [PubMed: 32761638].
  36. Mansoori P, Majdzadeh R, Abdi Z, Rudan I, Chan KY, Aarabi M, et al. Setting research priorities to achieve long-term health targets in Iran. J Glob Health. 2018;8(2):1-12. doi: 10.7189/jogh.08.020702. [PubMed: 30356511].
  37. Mertens E, Markey O, Geleijnse MJ, Lovegrove JA, Givens DI. Adherence to a healthy diet in relation to cardiovascular incidence and risk markers: evidence from the Caerphilly Prospective Study. Eur J Nutr. 2018;57(3):1245-58. Doi: 10.1007/s00394-017-1408-0. [PubMed: 28293738].
  38. de Bakker M, den Uijl I, Hoeve NT, van Domburg RT, Geleijnse ML, van den Berg-Emons RJ, et al. Association between exercise capacity and heart disease fact questionnaire during and after cardiac rehabilitation in acute coronary syndrome patients: a sub study of the opticare randomized controlled trial. Arch Phys Med Rehabil. 2020:101(4)650-7. doi: 10.1016/j.apmr.2019.11.017. [PubMed: 31904342].
  39. Anderson L, Oldridge N, Thompson, DR, Zwisler AD, Rees K, Martin N, et al. Exercise-based cardiac rehabilitation for coronary heart disease: Cochrane systematic review and meta-analysis. J Am Coll Cardiol. 2016;67(1):1–12. doi: 10.1016/j.jacc.2015.10.044. [PubMed: 26764059].
Iranian Red Crescent Medical Journal (IRCMJ)
Volume 24, Issue 6 - Serial Number 6
2022
Files
History
  • Receive Date: 29 December 2021
  • Revise Date: 27 May 2024
  • Accept Date: 27 January 2024
  • First Publish Date: 27 January 2024
  • Publish Date: 01 June 2022
Share
How to cite
Statistics