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

13 de julho de 2026 atualizado por: 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.

Visão geral do estudo

Status

Ainda não está recrutando

Condições

Intervenção / Tratamento

Descrição detalhada

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.

Tipo de estudo

Intervencional

Inscrição (Estimado)

82

Estágio

  • Não aplicável

Contactos e Locais

Esta seção fornece os detalhes de contato para aqueles que conduzem o estudo e informações sobre onde este estudo está sendo realizado.

Contato de estudo

  • Nome: Reva G GÜNDOĞAN, Asst. Prof.
  • Número de telefone: +905551822097
  • E-mail: r4a5reva@gmail.com

Locais de estudo

  • Turquia (Türkiye)
    • Besni
      • Adıyaman, Besni, Turquia (Türkiye), 02100
        • Adıyaman University
        • Contato:
          • Reva GÜNDOĞAN, Asst. Prof.
          • Número de telefone: 05551822097
          • E-mail: r4a5reva@gmail.com
        • Contato:

Critérios de participação

Os pesquisadores procuram pessoas que se encaixem em uma determinada descrição, chamada de critérios de elegibilidade. Alguns exemplos desses critérios são a condição geral de saúde de uma pessoa ou tratamentos anteriores.

Critérios de elegibilidade

Idades elegíveis para estudo

  • Adulto
  • Adulto mais velho

Aceita Voluntários Saudáveis

Não

Descrição

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,

Plano de estudo

Esta seção fornece detalhes do plano de estudo, incluindo como o estudo é projetado e o que o estudo está medindo.

Como o estudo é projetado?

Detalhes do projeto

  • Finalidade Principal: Cuidados de suporte
  • Alocação: Randomizado
  • Modelo Intervencional: Atribuição Paralela
  • Mascaramento: Dobro

Armas e Intervenções

Grupo de Participantes / Braço
Intervenção / Tratamento
Experimental: Individualized discharge education group
Experimental arm
Comportamental: 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.
Sem intervenção: Control group
Control arm

O que o estudo está medindo?

Medidas de resultados primários

Medida de resultado
Descrição da medida
Prazo
LACE index
Prazo: 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)
Prazo: 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)
Prazo: 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
Prazo: 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
Prazo: 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

Medidas de resultados secundários

Medida de resultado
Descrição da medida
Prazo
The Self-Care of Coronary Heart Disease Inventory (SC-CHDI)
Prazo: 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
Prazo: 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

Colaboradores e Investigadores

É aqui que você encontrará pessoas e organizações envolvidas com este estudo.

Patrocinador

Adiyaman Provincial Health Directorate

Investigadores

  • Investigador principal: Reva G GÜNDOĞAN, Asst. Prof., Adiyaman University

Publicações e links úteis

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Publicações Gerais

Datas de registro do estudo

Essas datas acompanham o progresso do registro do estudo e os envios de resumo dos resultados para ClinicalTrials.gov. Os registros do estudo e os resultados relatados são revisados ​​pela National Library of Medicine (NLM) para garantir que atendam aos padrões específicos de controle de qualidade antes de serem publicados no site público.

Datas Principais do Estudo

Início do estudo (Estimado)

1 de agosto de 2026

Conclusão Primária (Estimado)

31 de janeiro de 2027

Conclusão do estudo (Estimado)

1 de agosto de 2027

Datas de inscrição no estudo

Enviado pela primeira vez

1 de julho de 2026

Enviado pela primeira vez que atendeu aos critérios de CQ

13 de julho de 2026

Primeira postagem (Real)

14 de julho de 2026

Atualizações de registro de estudo

Última Atualização Postada (Real)

14 de julho de 2026

Última atualização enviada que atendeu aos critérios de controle de qualidade

13 de julho de 2026

Última verificação

1 de julho de 2026

Mais Informações

Termos relacionados a este estudo

Palavras-chave

Termos MeSH relevantes adicionais

Outros números de identificação do estudo

  • 2026/4-21

Plano para dados de participantes individuais (IPD)

Planeja compartilhar dados de participantes individuais (IPD)?

NÃO

Descrição do plano IPD

Data can be shared with researchers upon request.

Informações sobre medicamentos e dispositivos, documentos de estudo

Estuda um medicamento regulamentado pela FDA dos EUA

Não

Estuda um produto de dispositivo regulamentado pela FDA dos EUA

Não

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