Individualized Discharge Education in High-Risk Myocardial Infarction Patients (MI)
2026년 7월 13일 업데이트: Reva Gündoğan, Adiyaman Provincial Health Directorate
The Effect of Individualized Discharge Education on Readmission Rates in a High-Risk Population According to the LACE Index After Myocardial Infarction
The purpose of this clinical study is to evaluate whether individualized discharge education is effective in treating patients identified as high-risk based on the LACE index after a myocardial infarction.
Additionally, information will be gathered regarding the safety and outcomes of this education.
The key questions the study aims to answer are: Does individualized discharge education reduce hospital readmission rates for patients identified as high-risk after a myocardial infarction?
Does this education improve patients' treatment adherence, self-care levels, and quality of life?
Researchers will compare the effectiveness of individualized discharge education against routine care.
Participants will:Receive individualized discharge education prior to discharge if they meet the high-risk criteria, and receive a comprehensive educational brochure.
Be followed up via telephone three days a week while at home to monitor their care practices and hospital visits.
Participate in follow-up assessments at the 1st month (Follow-up 1) and 3rd month (Follow-up 3) to complete the Coronary Heart Disease Self-Care Inventory and the HeartQoL scale.
연구 개요
상세 설명
This study is a controlled research project examining the impact of individualized discharge education on clinical outcomes in patients identified as "high-risk" following a myocardial infarction (MI) using the LACE index.
The study aims to determine the role of patient education and follow-up during the post-cardiovascular event care process in reducing hospital readmission rates.
The fundamental interventions and processes to be carried out within the scope of the research are as follows:Risk Classification: Prior to discharge, patients treated in the cardiology clinic will be assessed using the LACE index, which includes length of hospital stay, acuity of admission, comorbidities, and emergency department visits within the previous 6 months.
Patients with a LACE score of 10 or higher will be classified as "high-risk" and included in the study.
Educational Intervention: The intervention group will receive a structured discharge education program tailored to the patients' clinical characteristics, educational levels, and risk profiles.
During the education process, a comprehensive brochure containing all relevant information will be provided.
The control group will continue to receive the hospital's standard routine care.
Monitoring and Follow-up: Patients will be followed for 3 months during the post-discharge period.
Patients in the intervention group will be contacted by telephone 3 days a week while at home to monitor their self-care practices and hospital visits.
Assessment Points: Research data will be collected before discharge (Follow-up 0), at the 1st month post-discharge (Follow-up 1), and at the 3rd month (Follow-up 3).
During this process, patients' readmission statuses will be recorded, and clinical changes will be compared using the Percutaneous Coronary Intervention Information Needs Scale (NCPI-10), the Self-Care of Coronary Heart Disease Inventory (SC-CHDI), and the HeartQoL scale.
Data Analysis: The collected data will be subjected to statistical analysis using SPSS 29 software to evidence-based demonstrate the effectiveness of individualized nursing education in improving patient outcomes.
연구 유형
중재적
등록 (추정된)
82
단계
- 해당 없음
연락처 및 위치
이 섹션에서는 연구를 수행하는 사람들의 연락처 정보와 이 연구가 수행되는 장소에 대한 정보를 제공합니다.
연구 연락처
- 이름: Reva G GÜNDOĞAN, Asst. Prof.
- 전화번호: +905551822097
- 이메일: r4a5reva@gmail.com
연구 장소
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Besni
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Adıyaman, Besni, 터키 (Türkiye), 02100
- Adıyaman University
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연락하다:
- Reva GÜNDOĞAN, Asst. Prof.
- 전화번호: 05551822097
- 이메일: r4a5reva@gmail.com
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연락하다:
- Sevim Güler, Nurse PhD
- 전화번호: +905055894983
- 이메일: sdegerguler@gmail.com
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참여기준
연구원은 적격성 기준이라는 특정 설명에 맞는 사람을 찾습니다. 이러한 기준의 몇 가지 예는 개인의 일반적인 건강 상태 또는 이전 치료입니다.
자격 기준
공부할 수 있는 나이
- 성인
- 고령자
건강한 자원 봉사자를 받아들입니다
아니
설명
Inclusion Criteria:
- Being over 18 years of age,
- Not having a cognitive disorder,
- Not having a history of psychiatric disorders,
- Being open to communication,
- Not having hearing, visual or speech impairments,
- Having a LACE index score of 10 or higher,
- Being willing to participate in the research.
Exclusion Criteria:
- Refusal to participate in the study
- Having a LACE index score below 10
- Not having a cognitive impairment,
공부 계획
이 섹션에서는 연구 설계 방법과 연구가 측정하는 내용을 포함하여 연구 계획에 대한 세부 정보를 제공합니다.
연구는 어떻게 설계됩니까?
디자인 세부사항
- 주 목적: 지지 요법
- 할당: 무작위
- 중재 모델: 병렬 할당
- 마스킹: 더블
무기와 개입
참가자 그룹 / 팔 |
개입 / 치료 |
|---|---|
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실험적: Individualized discharge education group
Experimental arm
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Education will cover the following topics: Disease Knowledge and Process Management: Definition of myocardial infarction, long-term management of the disease, risk of recurrence, and recognition of complication symptoms. Adherence to Medication Therapy: Regular use of medications, their effects, and methods of administration. Management of Comorbidities: Monitoring and managing existing co-occurring conditions as part of the overall care plan. Self-Care and Lifestyle Modifications: Nutrition: Adopting low-fat dietary habits that support heart health. Physical Activity: The importance of regular exercise and a safe activity plan. Risk Factor Control: Smoking cessation and avoiding smoke-filled environments, weight control, and blood pressure monitoring. Symptom Management: Recognizing potential symptoms and the necessary actions to take in such situations . Psychosocial Support: Strategies for managing disease-related stress and improving quality of life. |
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간섭 없음: Control group
Control arm
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연구는 무엇을 측정합니까?
주요 결과 측정
결과 측정 |
측정값 설명 |
기간 |
|---|---|---|
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LACE index
기간: Day 1
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LACE (Length of stay, Acuity of admission, Comorbidity, Emergency department visits) Index: The LACE index was first developed by van Walraven et al. to estimate the risk of unplanned readmission or death within 30 days of hospital discharge in medical and surgical patients.
The model was derived and validated based on administrative data with a C-statistic of 0.68.
The model includes length of hospital stay (L), severity of admission (A), comorbidities of patients (C), and the number of emergency department visits within six months prior to admission (E).
Scores ranging from "0" to "19" and greater than ten are considered a high risk for 30-day readmission.
Higher scores indicate a high risk of readmission.
This tool is widely used primarily due to its simplicity and usability in daily clinical practice.
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Day 1
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Percutaneous Coronary Intervention Information Needs Scale (NCPI-10)
기간: Day 1
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Percutaneous Coronary Intervention Information Needs Scale (NCPI-10): This scale is a 10-item scale that assesses the information needs of patients undergoing percutaneous coronary intervention (PCI) .
The Turkish validity and reliability study was conducted by Tüllüce et al. in 2025.
A four-point Likert scale was used to answer all items in the scale.
The total score of each result is between 10-40.
As the importance level score of the information need increases, the importance level for the patient increases.
As the level of fulfillment of the information need score increases, the level of fulfillment of the needs increases.
The Cronbach alpha internal consistency coefficient of the scales was found to be 0.98 for the importance level of the information need and 0.98 for the degree of fulfillment.
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Day 1
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The Self-Care of Coronary Heart Disease Inventory (SC-CHDI)
기간: Day 1
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The Self-Care of Coronary Heart Disease Inventory (SC-CHDI) was developed by Dickson et al. to assess the self-care levels of individuals with coronary heart disease.
Its Turkish validity and reliability study was conducted by Bayrak and Oğuz (2020).
The scale consists of 22 items and three sub-dimensions: maintaining self-care (10 items), managing self-care (6 items), and self-care confidence (6 items).
Items are generally scored on a Likert scale from 1=never, 2=sometimes, 3=frequently, and 4=always, with some items in the self-care management sub-dimension being rated between 0 and 4. A total score is not obtained from the scale; each sub-dimension is evaluated separately, and higher scores indicate a better level of self-care.
In the Turkish adaptation study, the Cronbach's alpha coefficients of the scale were found to be 0.63 for maintaining self-care, 0.76 for managing self-care, and 0.95 for self-care confidence.
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Day 1
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Heart Quality of Life (HeartQoL) Scale
기간: Day 1
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Heart Quality of Life (HeartQoL) Scale: The Heart Quality of Life (HeartQoL) Scale was developed to measure quality of life in individuals with ischemic heart disease .
A Turkish validity and reliability study was conducted by Duğan & Bektaş in 2020.
The original scale included patients with angina pectoris, myocardial infarction, and ischemic heart failure within ischemic heart disease.
The scale consists of 14 items, divided into two sub-dimensions: physical (10 items; 1, 2, 3, 4, 5, 6, 7, 8, 13, 14) and emotional characteristics (4 items; 9, 10, 11, 12).
Each item in the HeartQoL Scale is scored between 0 and 3; 3 represents "no discomfort" and 0 represents "very discomfort".
In the evaluation of the scale, high scores indicate the absence of dysfunction.
The Cronbach's alpha reliability coefficient was found to be 0.88 overall, and between 0.74 and 0.87 in its sub-dimensions.
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Day 1
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Personal Information Form
기간: Day 1
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Personal Information Form: Prepared by researchers through a literature review, this form will include 22 questions covering socioeconomic and disease information, as well as systolic blood pressure, diastolic blood pressure, fasting blood glucose, total cholesterol, triglycerides, HDL, LDL, and BMI values.
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Day 1
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2차 결과 측정
결과 측정 |
측정값 설명 |
기간 |
|---|---|---|
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The Self-Care of Coronary Heart Disease Inventory (SC-CHDI)
기간: Day 1, first month and third month
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The Self-Care of Coronary Heart Disease Inventory (SC-CHDI) was developed by Dickson et al. to assess the self-care levels of individuals with coronary heart disease.
Its Turkish validity and reliability study was conducted by Bayrak and Oğuz (2020) .
The scale consists of 22 items and three sub-dimensions: maintaining self-care (10 items), managing self-care (6 items), and self-care confidence (6 items).
Items are generally scored on a Likert scale from 1=never, 2=sometimes, 3=frequently, and 4=always, with some items in the self-care management sub-dimension being rated between 0 and 4. A total score is not obtained from the scale; each sub-dimension is evaluated separately, and higher scores indicate a better level of self-care.
In the Turkish adaptation study, the Cronbach's alpha coefficients of the scale were found to be 0.63 for maintaining self-care, 0.76 for managing self-care, and 0.95 for self-care confidence.
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Day 1, first month and third month
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Heart Quality of Life (HeartQoL) Scale: The Heart Quality of Life (HeartQoL) Scale
기간: Day 1, first month and third month
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Heart Quality of Life (HeartQoL) Scale: The Heart Quality of Life (HeartQoL) Scale was developed to measure quality of life in individuals with ischemic heart disease .
A Turkish validity and reliability study was conducted by Duğan & Bektaş in 2020.
The original scale included patients with angina pectoris, myocardial infarction, and ischemic heart failure within ischemic heart disease.
The scale consists of 14 items, divided into two sub-dimensions: physical (10 items; 1, 2, 3, 4, 5, 6, 7, 8, 13, 14) and emotional characteristics (4 items; 9, 10, 11, 12).
Each item in the HeartQoL Scale is scored between 0 and 3; 3 represents "no discomfort" and 0 represents "very discomfort".
In the evaluation of the scale, high scores indicate the absence of dysfunction.
The Cronbach's alpha reliability coefficient was found to be 0.88 overall, and between 0.74 and 0.87 in its sub-dimensions .
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Day 1, first month and third month
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공동 작업자 및 조사자
여기에서 이 연구와 관련된 사람과 조직을 찾을 수 있습니다.
수사관
- 수석 연구원: Reva G GÜNDOĞAN, Asst. Prof., Adiyaman University
간행물 및 유용한 링크
연구에 대한 정보 입력을 담당하는 사람이 자발적으로 이러한 간행물을 제공합니다. 이것은 연구와 관련된 모든 것에 관한 것일 수 있습니다.
일반 간행물
- Zhang P, Hu YD, Xing FM, Li CZ, Lan WF, Zhang XL. Effects of a nurse-led transitional care program on clinical outcomes, health-related knowledge, physical and mental health status among Chinese patients with coronary artery disease: A randomized controlled trial. Int J Nurs Stud. 2017 Sep;74:34-43. doi: 10.1016/j.ijnurstu.2017.04.004. Epub 2017 Apr 14.
- Vaughan Dickson V, Lee CS, Yehle KS, Mola A, Faulkner KM, Riegel B. Psychometric Testing of the Self-Care of Coronary Heart Disease Inventory (SC-CHDI). Res Nurs Health. 2017 Feb;40(1):15-22. doi: 10.1002/nur.21755. Epub 2016 Sep 30.
- Lizcano-Alvarez A, Carretero-Julian L, Talavera-Saez A, Cristobal-Zarate B, Cid-Exposito MG, Alameda-Cuesta A; REccAP Group (Red de Enfermeria de Cuidados Cardiovasculares en Atencion Primaria). Intensive nurse-led follow-up in primary care to improve self-management and compliance behaviour after myocardial infarction. Nurs Open. 2023 Aug;10(8):5211-5224. doi: 10.1002/nop2.1758. Epub 2023 Apr 21.
- Oldridge N, Hofer S, McGee H, Conroy R, Doyle F, Saner H; (for the HeartQoL Project Investigators). The HeartQoL: part II. Validation of a new core health-related quality of life questionnaire for patients with ischemic heart disease. Eur J Prev Cardiol. 2014 Jan;21(1):98-106. doi: 10.1177/2047487312450545. Epub 2012 Jul 20.
- Bayrak B, Oguz S. Validity and reliability of the Turkish version of the Self-Care of Coronary Heart Disease Inventory. Int J Nurs Pract. 2021 Feb;27(1):e12847. doi: 10.1111/ijn.12847. Epub 2020 May 5.
- Tsoulou V, Vasilopoulos G, Kapadohos T, Panoutsopoulos G, Kalogianni A, Toulia G, Koutelekos I, Gerogianni G, Polikandrioti M. Information Needs in Percutaneous Coronary Artery Intervention: Validation and Reliability Analysis of NPCI-10 Item Scale. Cureus. 2021 Jan 15;13(1):e12718. doi: 10.7759/cureus.12718.
- Yazdan-Ashoori P, Lee SF, Ibrahim Q, Van Spall HG. Utility of the LACE index at the bedside in predicting 30-day readmission or death in patients hospitalized with heart failure. Am Heart J. 2016 Sep;179:51-8. doi: 10.1016/j.ahj.2016.06.007. Epub 2016 Jun 18.
- Duğan, Ö., & Bektaş, H. (2020). Koroner arter hastalarında Kalp Yaşam Kalitesi Ölçeği'nin Türkçeye uyarlama çalışması. Turkish Journal of Cardiovascular Nursing, 11(25), 71-81. https://doi.org/10.5543/khd.2020.38278
- Rajaguru V, Han W, Kim TH, Shin J, Lee SG. LACE Index to Predict the High Risk of 30-Day Readmission: A Systematic Review and Meta-Analysis. J Pers Med. 2022 Mar 30;12(4):545. doi: 10.3390/jpm12040545.
- Robinson R, Bhattarai M, Hudali T, Vogler C. Predictors of 30-day hospital readmission: The direct comparison of number of discharge medications to the HOSPITAL score and LACE index. Future Healthc J. 2019 Oct;6(3):209-214. doi: 10.7861/fhj.2018-0039.
연구 기록 날짜
이 날짜는 ClinicalTrials.gov에 대한 연구 기록 및 요약 결과 제출의 진행 상황을 추적합니다. 연구 기록 및 보고된 결과는 공개 웹사이트에 게시되기 전에 특정 품질 관리 기준을 충족하는지 확인하기 위해 국립 의학 도서관(NLM)에서 검토합니다.
연구 주요 날짜
연구 시작 (추정된)
2026년 8월 1일
기본 완료 (추정된)
2027년 1월 31일
연구 완료 (추정된)
2027년 8월 1일
연구 등록 날짜
최초 제출
2026년 7월 1일
QC 기준을 충족하는 최초 제출
2026년 7월 13일
처음 게시됨 (실제)
2026년 7월 14일
연구 기록 업데이트
마지막 업데이트 게시됨 (실제)
2026년 7월 14일
QC 기준을 충족하는 마지막 업데이트 제출
2026년 7월 13일
마지막으로 확인됨
2026년 7월 1일
추가 정보
이 연구와 관련된 용어
기타 연구 ID 번호
- 2026/4-21
개별 참가자 데이터(IPD) 계획
개별 참가자 데이터(IPD)를 공유할 계획입니까?
아니요
IPD 계획 설명
Data can be shared with researchers upon request.
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이 정보는 변경 없이 clinicaltrials.gov 웹사이트에서 직접 가져온 것입니다. 귀하의 연구 세부 정보를 변경, 제거 또는 업데이트하도록 요청하는 경우 register@clinicaltrials.gov. 문의하십시오. 변경 사항이 clinicaltrials.gov에 구현되는 즉시 저희 웹사이트에도 자동으로 업데이트됩니다. .