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CARDIOVASCULAR JOURNAL OF AFRICA • Volume 25, No 6, November/December 2014
262
AFRICA
It has been established in many studies that in-patient and
discharge education is essential and beneficial to decrease anxiety
levels and depression, hospital re-admissions, non-adherence to
medication, and to improve quality of life, survival, and to
enable patients to retain a sense of control in their lives.
7,8,13
Education at the time of hospital discharge provides improved
clinical outcomes, increased adherence to self-care measures, and
reduced cost of care in patients with cardiac disease.
6
Therefore, patient education by nurses during the
hospitalisation period is suggested in the common guidelines as
part of the routine pharmacological and surgical treatment of
patients with cardiovascular diseases.
12
The Joint Commission on
Accreditation of Healthcare Organisation defined the standards
of patient education by nurses.
11
However, there are currently
no guidelines or standards on how to educate cardiovascular
surgery patients for discharge with regard to the amount or
content of the information necessary to be effective. Therefore
we aimed to compare the effectiveness of standard and patient-
targeted in-patient education in decreasing patients’ anxiety
levels in the cardiovascular clinic.
To measure patients’ learning needs to manage their
healthcare at home after discharge from hospital, we assessed
them using the PLNS.
17,18
We modified the standard education
Table 4. Effect of socio-demographic variables on the change in STAI anxiety scores with education
Group 1 (standard education, n
=
98)
Group 2 (individualised education, n
=
100)
Change in state anxi-
ety with education
p
-value
Change in trait anxi-
ety with education
p
-value
Change in state anxi-
ety with education
p
-value
Change in trait anxi-
ety with education
p
-value
Gender
Male
–0.58
±
5.51
0.922
2.80
±
7.78
0.017
28.42
±
4.50
0.513
12.33
±
3.72
0.410
Female
–0.76
±
6.02
7.32
±
8.99
28.00
±
3.80
12.79
±
3.64
Marital status
Married
–0.47
±
5.51
0.265
3.78
±
8.02
0.750
28.44
±
4.21
0.427
12.67
±
3.65
0.017
Single
–3.00
±
7.18
6.50
±
12.49
26.17
±
5.57
9.17
±
2.56
Having children
Yes
–0.72
±
5.59
0.314
3.88
±
8.06
0.860
28.13
±
4.30
0.101
12.45
±
3.71
0.821
No
4.00
±
7.07
7.50
±
21.92
31.00
±
3.69
12.67
±
3.56
Education
Primary school
–0.50
±
5.80
0.965
4.49
±
7.85
0.403
28.10
±
4.13
0.895
12.00
±
3.67
0.131
Middle school
–0.90
±
2.77
5.40
±
6.92
29.54
±
5.08
14.31
±
4.55
High school
–1.00
±
6.86
–1.00
±
11.26
29.50
±
5.72
12.67
±
2.16
University
–2.00
±
7.21
–3.33
±
13.65
27.00
±
3.61
14.00
±
1.00
Illiterate
27.70
±
4.08
12.60
±
3.37
Working status
Working
–2.27
±
4.86
0.056
2.07
±
9.27
0.331
29.77
±
4.03
0.029
12.93
±
3.50
0.339
Not working
0.10
±
5.80
4.78
±
7.76
27.67
±
4.29
12.26
±
3.76
Smoking
Yes
–0.56
±
4.73
0.936
4.19
±
9.10
0.790
28.74
±
4.09
0.555
13.03
±
4.07
0.248
No
–0.65
±
5.95
3.86
±
8.04
28.10
±
4.41
12.20
±
3.50
Alcohol consumption
Yes
–1.08
±
3.83
0.761
2.92
±
8.95
0.774
28.56
±
3.99
0.850
12.33
±
3.53
0.850
No
–0.56
±
5.83
4.09
±
8.25
28.24
±
4.39
12.49
±
3.74
Exercise
Yes
–2.00
±
5.96
0.150
2.17
±
7.82
0.142
28.50
±
4.32
0.618
13.29
±
3.97
0.048
No
–0.31
±
5.53
4.35
±
8.40
28.12
±
4.32
11.69
±
3.25
Frequency of exercise
None
–0.23
±
5.07
0.552
3.95
±
7.78
0.996
28.12
±
4.32
0.393
11.69
±
3.25
0.248
3–4 times/week
–0.50
±
5.25
4.42
±
8.59
28.22
±
3.35
13.78
±
5.52
Daily
–3.00
±
7.94
2.60
±
11.09
27.83
±
4.36
13.23
±
3.70
1–2 times/week
–0.60
±
6.10
4.35
±
8.61
31.00
±
4.58
13.00
±
3.46
On a diet
Yes
–0.50
±
5.36
0.944
3.33
±
6.88
0.459
28.67
±
4.42
0.650
13.25
±
4.02
0.172
No
–0.66
±
5.73
4.15
±
8.74
28.09
±
4.26
12.02
±
3.43
Table 5. Correlation (
r
, correlation coefficient)
between change in anxiety score from the STAI and age,
weight and income level
Group 1 (standard
education,
n
=
98)
Group 2 (individualised
education,
n
=
100)
Change
in state
anxiety with
education
Change
in trait
anxiety with
education
Change
in state
anxiety with
education
Change
in trait
anxiety with
education
Age (years)
r
p
–0.072
0.479
–0.073
0.473
–0.172
0.088
–0.020
0.845
Weight (kg)
r
p
0.024
0.818
–0.257
0.011
–0.133
0.188
–0.057
0.575
Income
r
p
–0.093
0.360
0.127
0.211
–0.051
0.611
0.091
0.370