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Effects on self-management behaviour after an individual nurse-led counselling programme for patients discharged early after myocardial infarction: A 12-month randomised controlled follow-up

Gunhild Brørs, Tone M Norekvål, Liv Heidi Skotnes, Ulla Romild, Bengt Fridlund


Rationale, aims and objectives: Secondary prevention programmes reduce cardiovascular risk, but few studies have evaluated whether a nurse-led intervention for patients discharged early after myocardial infarction (MI) promotes self-management behaviour. The aim of this study was to evaluate the effect of an individual nurse-led counselling programme combined with usual care versus usual care alone on self-management behaviour of patients discharged early after MI.

Methods: Seventy-one patients were randomised to either the usual care (control group) or to the usual care combined with a 6-month follow-up individual nurse-led counselling programme (intervention group). The latter consisted of 3 face-to-face sessions and 2 telephone contacts over 6 months, starting 2 weeks after discharge. Primary outcome measures at 6- and 12-month follow-up was the difference in self-management behaviour assessed by the patient activation measure (PAM). Secondary outcomes included physical activity and diet habit.

Results: The median age of patients was 63 years and 70% were males. The intervention group had a greater effect on their PAM scores and had higher average intensity and longer duration of physical activity at 6-months and a higher summary index of weekly physical activity at 6- and 12-month follow-up compared to the control group. There was a clinically relevant effect on diet score within the intervention group at 6- and 12-month follow-up.

Conclusions: An individual nurse-led counselling programme combined with usual care for post-MI treatment, had an effect on self-management behaviour at 6-month follow-up. The results also indicate an effect on health behaviour at 12-month follow-up.


Counselling, health behaviour, myocardial infarction, nurse-led, person-centered healthcare, randomised controlled trial, self-management

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