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Individualized Discharge Education in High-Risk Myocardial Infarction Patients (MI)

13. juli 2026 oppdatert av: 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.

Studieoversikt

Status

Har ikke rekruttert ennå

Forhold

Intervensjon / Behandling

Detaljert beskrivelse

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.

Studietype

Intervensjonell

Registrering (Antatt)

82

Fase

  • Ikke aktuelt

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiekontakt

  • Navn: Reva G GÜNDOĞAN, Asst. Prof.
  • Telefonnummer: +905551822097
  • E-post: r4a5reva@gmail.com

Studiesteder

  • Tyrkia (Türkiye)
    • Besni
      • Adıyaman, Besni, Tyrkia (Türkiye), 02100
        • Adıyaman University
        • Ta kontakt med:
        • Ta kontakt med:

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

  • Voksen
  • Eldre voksen

Tar imot friske frivillige

Nei

Beskrivelse

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,

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Støttende omsorg
  • Tildeling: Randomisert
  • Intervensjonsmodell: Parallell tildeling
  • Masking: Dobbelt

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Eksperimentell: Individualized discharge education group
Experimental arm
Atferdsmessig: Individualized discharge education

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.
Ingen inngripen: Control group
Control arm

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
LACE index
Tidsramme: Day 1
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.
Day 1
Percutaneous Coronary Intervention Information Needs Scale (NCPI-10)
Tidsramme: Day 1
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.
Day 1
The Self-Care of Coronary Heart Disease Inventory (SC-CHDI)
Tidsramme: Day 1
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.
Day 1
Heart Quality of Life (HeartQoL) Scale
Tidsramme: Day 1
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.
Day 1
Personal Information Form
Tidsramme: Day 1
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.
Day 1

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
The Self-Care of Coronary Heart Disease Inventory (SC-CHDI)
Tidsramme: Day 1, first month and third month
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.
Day 1, first month and third month
Heart Quality of Life (HeartQoL) Scale: The Heart Quality of Life (HeartQoL) Scale
Tidsramme: Day 1, first month and third month
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 .
Day 1, first month and third month

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Sponsor

Adiyaman Provincial Health Directorate

Etterforskere

  • Hovedetterforsker: Reva G GÜNDOĞAN, Asst. Prof., Adiyaman University

Publikasjoner og nyttige lenker

Den som er ansvarlig for å legge inn informasjon om studien leverer frivillig disse publikasjonene. Disse kan handle om alt relatert til studiet.

Generelle publikasjoner

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart (Antatt)

1. august 2026

Primær fullføring (Antatt)

31. januar 2027

Studiet fullført (Antatt)

1. august 2027

Datoer for studieregistrering

Først innsendt

1. juli 2026

Først innsendt som oppfylte QC-kriteriene

13. juli 2026

Først lagt ut (Faktiske)

14. juli 2026

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

14. juli 2026

Siste oppdatering sendt inn som oppfylte QC-kriteriene

13. juli 2026

Sist bekreftet

1. juli 2026

Mer informasjon

Begreper knyttet til denne studien

Nøkkelord

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre

  • 2026/4-21

Plan for individuelle deltakerdata (IPD)

Planlegger du å dele individuelle deltakerdata (IPD)?

NEI

IPD-planbeskrivelse

Data can be shared with researchers upon request.

Legemiddel- og utstyrsinformasjon, studiedokumenter

Studerer et amerikansk FDA-regulert medikamentprodukt

Nei

Studerer et amerikansk FDA-regulert enhetsprodukt

Nei

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