The influence of treatment modality on illness perception and secondary prevention outcomes among patients with acute myocardial infarction.
Ahmed Mohammad Al-Smadi, Loai Issa Tawalbeh, Ala Ashour and 4 others
PMID 31406752WHAT IT FOUND
Six months after heart attack, patients who had emergency PCI described their illness as more acute and felt less personal control; smoking fell in all groups, but BMI and LDL did not change.
Key findings
01Patients who had primary PCI described their illness as more acute than patients who had thrombolytic therapy or NSTEMI care.
02Patients who had primary PCI reported lower personal control than thrombolytic patients and higher treatment control than both thrombolytic and NSTEMI patients.
03At follow-up, BMI and LDL did not change significantly, but smoking decreased in each group; cholesterol, blood pressure and activity showed group-specific changes.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Patients were not randomly assigned to treatment, and the groups differed in length of stay and angiography results, so treatment cannot be separated from patient differences. The sample was a convenience sample from one Jordanian centre where cardiac rehabilitation was not available, so the findings may not apply to other health systems. Follow-up was only 6 months, and 11 patients died, 5 were not reachable and 4 refused follow-up. The study observed usual care and did not test whether assessing illness perception or giving extra education changes outcomes.
The easy way to misread this
Do not conclude that primary PCI changed illness perception or prevention outcomes. The treatment groups were not randomly assigned and differed in hospital stay and clinical results, so these are associations in usual care, not proof that the procedure changed beliefs or behaviour.