Effectiveness of nurse-led counselling and education on self-efficacy of patients with acute coronary syndrome: A randomized controlled trial.

The study was done at one academic hospital in Iran and enrolled patients under 75, so results may not apply to older or differently situated ACS populations. Eligible patients were selected by convenience sampling, not random sampling from all ACS patients. Follow-up was only 1 month, so it does not show whether the effect lasts or changes long-term recovery. The same researcher delivered the counselling and collected the data, and participants were not blinded, which can bias self-reported scores. The outcome was self-reported cardiac self-efficacy only; no readmission, emergency visits, mortality, medication adherence, or physical activity outcomes were measured. The intervention combined several counselling and education components, so the effect of any single part cannot be separated. Nurses would need additional time, training, and staffing to deliver the programme, as the authors note resource shortages may prevent implementation.

The authors declared no conflict of interest. The funder is named as Shahroud University of Medical Sciences, and one author was responsible for funding acquisition.

Do not conclude that nurse-led counselling and education prevents heart attacks, readmissions, or death. The trial measured only self-reported cardiac self-efficacy at 1 month, and the intervention was added to routine discharge care, so long-term clinical benefit and the contribution of each counselling component are not established.