Other: Self care learning needs of people with chronic angina as perceived by clinicians and patients

Abstract

Chronic stable angina (CSA) is the cardinal symptom of ischemic heart disease (IHD). The current success of treating acute cardiovascular problems through tertiary emergency, medical, surgical and pharmacological services has overshadowed the need to provide secondary prevention strategies as well. Consequently, those living with CSA and IHD do not receive secondary preventative support to meet their self care needs in the community; they must rely heavily on tertiary services for intervention during potentially preventable acute episodes. To identify the self-care learning needs of those living with CSA as perceived by CSA patients compared with clinicians. Four focus groups were conducted to include two with chronic angina patients and two with clinicians. Each session included 6-8 participants and consisted of a semi-structured interview lasting approximately 1-12 hours. All participants were asked to respond to questions in an audio taped discussion format. Braden's Self-help model was used to guide the content analysis of the transcribed data. These data were coded for major themes, yielding a 95% inter-rater agreement between the two nurse-raters. Clinicians emphasized that chronic angina patients needed help to understand the nature of angina including pathophysiology and symptomatic manifestations that they will need to manage. Angina patients emphasized their need to learn how to minimize and manage day-to-day symptoms and how to cope with angina-induced physical limitations.. Dealing with both physical, emotional and role-related limitations and uncertainty related to symptom interpretation were identified by both groups as high learning priorities. This study has identified differences and similarities among what patients and clinicians perceive as self-care learning priorities for CSA patients. These data have given direction to a secondary prevention education intervention for chronic angina patients.