Nurse-led Education Intervention Research Articles

Effectiveness of nurse-led educational intervention package on back pain and activity of daily living in primigravidae women with back pain

Background: The primigravida women often have more complaints of back pain during pregnancy. Pregnant women reported that back pain might affect the activities of daily routine e.g. walking, climbing stairs, sitting, and women may expect help from family members.Methods: A quasi-experimental study was directed on primigravidae women visiting antenatal outpatient department (OPD) of All India Institute of Medical Sciences (AIIMS) Jodhpur. An absolute of 60 primigravidae women (30 in each experimental and control group) were incorporated through the non-probability consecutive sampling method.Results: The pre-test score uncovered that the majority of the women (70%) in the experimental group and (60%) in the control group revealed moderate pain. The post-test score uncovered that (56.6%) in the experimental group detailed mild pain and 53.3% of women in the control group reported severe pain. When compared with the pre-test, the pain score of members in the experimental group was diminished and in the control group, the pain score was increased in post-test (p≤0.000). No critical contrast was found in the activity of daily living in the experimental and control group. For analysis, paired and unpaired t-test, x2, and Fisher exact tests were used.Conclusions: The majority of primigravidae women had back pain during pregnancy and participants recognized prolong sitting as the most well-known aggravating factor. It was discovered that there was a significant distinction in pain scores between pre-test and post-test in the experimental and control group.

Motivational interviewing to improve self-management in youth with type 1 diabetes: A randomized clinical trial

PurposeEffective interventions are needed to help adolescents with T1D develop independent self-management skills to prevent commonly observed deterioration of disease self-management resulting in poor health outcomes. Using a prospective RCT design, we assessed the impact of a nurse-led education program based on motivational interviewing (MI) in youth with Type 1 diabetes (T1D). Design and methodsAfter parental consent and youth assent, we prospectively randomized 66 adolescents 13–18 years old with T1D to either usual care (every 3 months visit with pediatric endocrinologist) or usual care supplemented by 2 in-person and 4 follow-up phone calls with a nurse educator in a pediatric endocrinology clinic of the University Hospital Farhat Hached, Sousse, Tunisia. We used MI sessions to support youth general and disease specific self-management skills. Outcomes were change, between baseline and 6 months, in TRAQ (a validated measure of youth self-management) scores and HbA1c values. ResultsMean TRAQ scores (based on a 5-point Likert scale) increased by 1.44 points (s.d. = 0.56) in the Intervention Group versus 0.26 points (s.d. = 0.34) in the control group (p < 0.001). The mean HbA1C value decreased in the intervention group by 0.95 units versus a decrease of 0.12 units in the control group (p = 0.047). ConclusionWe found that a brief, nurse-led MI-based educational intervention, integrated into specialty pediatric care, resulted in a significant improvement in both self-reported self-management skills and in HbA1c values.Trial registration: Registered in ClinicalTrials.gov Identifier: NCT04798937

Nurse-led educational interventions for anxiety management in cancer survivors: a systematic review and meta-analysis.

This systematic review and meta-analysis was aimed toward evaluating the effectiveness of nurse-led educational interventions in anxiety management in cancer survivors. The electronic databases including Embase, PubMed, CINAHL Complete, the Cochrane Central Register of Controlled Trials (CENTRAL), and ERIC and manual search were subjected to a systematic search from 2000 to March 2021. A systematic review andmeta-analysiswasconducted. A total of 1028 studies were identified through five electronic databases and manual search. Overall, 42 studies were included in this systematic review. In addition, 32 included studies also investigated the interventional effects in management of depression. Therefore, depression was set as the secondary outcome. The meta-analysis of 20 randomized controlled trials with 2936 participants showed that nurse-led educational interventions decreased cancer survivors' anxiety with a moderate effect size (ES: - 0.25; 95% CI, - 0.35 to - 0.15, p = 0.03). The meta-analysis of 15 studies with 1906 participants indicated that nurse-led educational interventions decreased cancer survivors' depression with a moderate effect size (ES: - 0.33; 95% CI, - 0.45 to - 0.21, p = 0.09). Evidence supports the effectiveness of nurse-led educational interventions for reducing anxiety and depression in cancer survivors. An individual approach, the combination of face-to-face interventions and materials, a duration of 6 months, and a maximum of 60 min for each session could be considered in the future when developing educational interventions to manage anxiety.

Effectiveness of Nurse-led Intervention to Improve Quality of life for Family Caregivers of Children with Leukemia: A Quasi-Experimental Study from Karachi Pakistan

Background: Acute lymphoblastic leukemia accounts for 25% of all cancers in children less than 15 years old. The treatment phase of leukemia is lengthy and takes 2-3 years. Due to prolonged treatment, family caregivers often become exhausted, highly distressed with low quality of life and unsatisfactory patient outcomes. Thus, caregivers need interventions such as adaptation strategies and access to support groups that enhance their wellbeing and improves their quality of life (QoL).&#x0D; Objectives: To determine the effectiveness of nurse-led structured educational intervention for family caregivers having a child diagnosed with leukemia and to examine the association between socio-demographic variables and quality of life of leukemia child caregiver.&#x0D; Methodology: A Quasi-Experimental pre-post-test design was applied at the tertiary care hospital of Karachi. A total of 74 family caregivers of leukemia children were recruited from outpatient and inpatient oncology departments using purposive sampling. The data was collected pre-intervention and post-intervention using QoL-FV. Intervention of educational session given in 30-45 minutes for 4 days and after 1month of intervention, posttest done by same questionnaire to estimate the effect of nurse-led education&#x0D; Results: Study findings revealed that mean score of overall QoL improved after one-month of nurse-led educational intervention 95+ 23 and had a significant difference in post-test QOL (&lt;0.001). The sub-dimensions of QoL such as physical wellbeing, psychological wellbeing, and social concern improved significantly in posttest interventions group (P&lt; 0.01). Whereas the spiritual wellbeing was found insignificant after interventions (p&gt;0.080). &#x0D; Conclusion: The study suggests that Nurse-Led education program is helpful to improve family caregivers' quality of life during the treatment journey of their leukemia patient. it must be considered and acknowledged with prime importance and caregivers should be supported by health care professionals.&#x0D; Recommendation: It should be an important aspect to include counseling sessions of families to improve their coping, problem solving and awareness.

Efficacy of a nurse-led patient education intervention in promoting safety skills of patients with inflammatory arthritis treated with biologics: a multicentre randomised clinical trial

ObjectiveTo evaluate the effect of a nurse-led patient education on safety skills of patients with inflammatory arthritis treated with biologic disease-modifying antirheumatic drugs (bDMARDs).MethodsThis is a multicentre, open-labelled, randomised controlled...

Development of A Nurse-Led Educational Intervention Program in Managing the Nutrition Impact Symptom Cluster in Patients with Nasopharyngeal Carcinoma following the Medical Research Council Framework

Objective:This article aimed to report the experience of developing a complex nurse-led, theory-driven, and evidence-based educational intervention program intended to manage the nutrition impact symptom cluster experienced by patients with nasopharyngeal carcinoma (NPC) during radiotherapy, based on the Medical Research Council (MRC) framework.Methods:The “development” and “feasibility and piloting” phases of the MRC framework were used to guide the intervention development. The development phase included identifying the evidence base through a systematic review, exploring the relevant and guiding theory to enhance the effectiveness of the intervention and conducting a qualitative study to identify the intervention modelling. For the feasibility and piloting phase, we conducted a pilot study to examine the feasibility and estimate the effectiveness of the intervention.Results:The systematic review revealed that nurse-led educational interventions were used commonly for symptom cluster management, with promising effectiveness. The theoretical foundation was provided by the Theory of Unpleasant Symptoms, which indicates that an educational intervention can help patients to manage symptom cluster by influencing psychological, situational, and physiological factors. The qualitative study further provided contents of the intervention based on the perspectives of NPC patients and health professionals. The resulting program involves a nurse-led, family caregiver involvement, educational intervention with two sessions that uses a booklet as a medium. The pilot study found that conducting the educational intervention program was feasible and it also had some favorable effects on managing the nutrition impact symptom cluster in NPC patients.Conclusions:The MRC framework provided a strong structure with which to develop a complex intervention for nutrition impact symptom cluster management through a theory-driven and evidence-based approach. The evaluation of the intervention, the delivery process and the mediation mechanism of change using a rigorous randomized controlled trial design is recommended.

Targeted Education for School Staff on Electronic Nicotine Delivery Systems: A Nurse Led Intervention.

There is a public health epidemic in adolescents' use of Electronic Nicotine Delivery Systems (ENDSs), also known as electronic cigarettes, vaping products, or JUULs. However, little is known about the level of knowledge school staff have about ENDS. The purpose of this study is to examine outcomes of a nurse-led educational intervention designed to increase school staff knowledge about ENDS. A descriptive, nonrandomly selected pre-test/post-test design was used with 125 Wisconsin school staff. Results revealed further educational needs of school staff in content areas including advertising to youth and flavoring of ENDS. Following the educational intervention, post-test results showed a significant overall improvement in participant knowledge scores. Recommendations include implementing nurse-led education about ENDS to a more diverse population of school staff. Providing nurse-led ENDS education to school staff offers an upstream, proactive approach for school nurses to help address this public health epidemic.

Factors Affecting Cancer Prevention Behaviors and Cancer Screening in First-Degree Relatives of Breast and Colorectal Cancer Patients in Korea: A Cross-Sectional Study.

First-degree relatives (FDRs) of cancer patients have a high risk of cancer due to a similar lifestyle and genetic predisposition. However, previous studies rarely examined the level of cancer prevention behaviors and screening and affecting factors in cancer patients' FDRs. This study aimed to describe the levels of cancer knowledge, attitudes toward cancer, cancer worry, perceived cancer risk, and cancer prevention behaviors and cancer screening in FDRs of breast and colorectal cancer patients. Moreover, it sought to identify factors affecting cancer prevention behavior and cancer screening. A cross-sectional, descriptive correlational design was used. The study enrolled 138 FDRs of breast and colorectal cancer patients. Participants completed self-administered questionnaires at a tertiary hospital in Seoul, Korea. Descriptive statistics, frequencies, chi-square test, independent t test, one-way analysis of variance (ANOVA), Pearson's correlation, multiple regression, and logistic regression were performed for data analysis. The levels of perceived cancer risk, cancer knowledge, attitude toward cancer, and cancer prevention behaviors were moderate, while the level of cancer worry was high. Ninety-two participants reported having undergone cancer screenings, but the types of screening were not associated with their family history. Age, gender, and attitude toward cancer affected cancer prevention behaviors. The cancer screening rate was higher in older participants, in women, and in patients' FDRs with a longer cancer diagnosis. Attitude was the modifiable factor for cancer prevention behaviors. Nurse-led educational and counseling interventions should be developed to improve attitude toward cancer among FDRs of cancer patients.

Accuracy of an adherence score and time in therapeutic range among patients on chronic use of vitamin K antagonists

To validate and analyze the accuracy of the Simonetti adherence score among patients on chronic use of vitamin K antagonists and their time in therapeutic range (TTR) of the international normalized ratio as a measure of quality of anticoagulation. A prospective cohort study with a nonrandomized intervention in patients from an anticoagulation center of a public hospital. Baseline data were collected from May to September 2017, and follow-up data were obtained eight months after a nurse-led educational intervention, which was given to all patients after consent form and after applying the adherence score (N=205). The intervention was undertaken through 30-40 min conversation about relevant factors that had been previously identified in the score derivation study, which comprised drug-drug interactions, inadequate OAC use, comorbidities, effects of food on vitamin K absorption, and invasive procedures. A receiver operating characteristic (ROC) curve was applied to validate the adherence score in terms of prediction of INR out of recommended therapeutic range. At baseline, mean adherence score was 44.69 and standard deviation (SD) was 18.37, and mean TTR was 41.07 (SD 15.40). Patients were reassessed after 8 months. At follow-up, there were significant improvements in mean adherence score 54.28 (SD 13.13), and in mean TTR 50.99 (SD 26.10). The Simonetti adherence score yielded high performance and accuracy in clinical practice among patients on chronic use of vitamin K antagonists. Our data indicate that nurse led educational intervention yielded favorable impact in terms of adherence score and TTR improvements.

Impact of nurse-initiated education on HeartScore in patients with hypertension: a randomised trial.

People with hypertension experience significant damage to major organs due to insufficient management of cardiovascular risk factors. To assess the impact of nurse-led educational interventions on the total cardiovascular risk among people with hypertension. the study was an interventional randomised study. The sample (n=92) was randomly assigned to the either the control or intervention group. The HeartScore tool was used to assess patients' total cardiovascular risk between December 2017 and March 2018. 56.6% of the control group and 55.4% of the intervention group were women, with a mean age of 64.4 years and 66.2 years respectively (P>0.05). Total cholesterol reduced in both groups; however, improvement was greater in the intervention group (P<0.05). Total cardiovascular risk fell in the intervention group from 4.75 to 4.33 (P>0.05), while the control group saw an increase in risk from 10.03 to 12.65 (P=0.035). Nurse-led educational interventions should be incorporated in the usual care of patients with hypertension, in order to achieve the best management of the condition.

A family nurse-led intervention for reducing health services’ utilization in individuals with chronic diseases: The ADVICE pilot study

ObjectivesIntensive health services’ utilization is common in older individuals affected by chronic diseases. This study assessed whether a structured family nurse-led educational intervention would be effective in reducing health services’ use (readmissions and/or emergency service access) among older people affected by chronic conditions. MethodsThis is a non-randomized before-after pilot study. A sample of 78 patients was recruited from two general practices in Italy and 70 among them were followed for 8 months. Standard home care was provided during the first four months’ period (months 1–4), followed by the educational intervention until the end of the study (months 5–8). The intervention, based on the teach-back method, consisted of by-weekly 60-min home sessions targeting aspects of the disease and its treatment, potential complications, medication adherence, and health behaviours. Rates of health services’ use were collected immediately before (T0), and after the interventions (T1). Differences in utilization rates were examined by the McNemar’s test. Potential factors associated with the risk of health services’ use were explored with a Cox proportional hazard regression model. ResultsThe sample (n = 78) was predominantly female (n = 50, 64.1%), and had a mean age of 76.2 (SD = 4.8) years. Diabetes mellitus was the most frequent disease (n = 27, 34.6%). McNemar’s test indicated a significant reduction in health services’ use at T1 (McNemar χ2 = 28.03, P < 0.001). Cox regressions indicated that time and patient education, as well as their interaction, were the only variables positively associated with the probability of health services’ use. ConclusionA teach-back intervention led by a family nurse practitioner has the potential to reduce health services’ use in older patients with chronic diseases.

Positive Impact of Targeted Educational Intervention in Children With Low Adherence to Growth Hormone Treatment Identified by Use of the Easypod™ Electronic Auto-injector Device

Background: It is important to identify patients with low adherence to recombinant human growth hormone (r-hGH) therapy and initiate actions to improve adherence. The Merck Patient Support Program (PSP) aims to raise the awareness of these patients and their parents of the importance of good adherence in achieving optimal growth outcomes. The easypod™ digitally-enhanced injection device provides accurate, reliable adherence data for the PSP by recording the exact dose, time and date of injections given. In this study, we aimed to measure the effect of an educational intervention on adherence in patients using the easypod™ device to deliver their r-GH therapy.Methods: This was a 12-month observational, retrospective cohort study. Patients previously identified by data recorded from their easypod™ injection device as having low adherence (<80%) were followed over the 6 months before and after a targeted educational visit by a PSP nurse. Patient adherence and demographic data were extracted from the PSP database. Statistical analyzes were carried out with STATA 15.0 software.Results: Data from 80 patients (65% male) with low adherence were analyzed. Patients were aged 2–18 (mean: 11.77) years with diagnoses of growth hormone deficiency (71.25%), small for gestational age (20%), Turner syndrome (7.50%) and chronic renal disease (1.25%). Duration of treatment was 0.40–11.13 (median: 3.62) years. At baseline, median adherence to r-hGH therapy was 67%; after the intervention it increased to 76%, a statistically significant median improvement of 9% (p = 0.0000, Wilcoxon signed-rank test). Additionally, 36% (29/80) of patients increased their adherence to r-hGH therapy to ‘good’ (≥80%). Both changes were clinically relevant.Conclusions: We conclude that a nurse-led educational intervention, supported by digital medication adherence monitoring, is a simple method to improve adherence to r-hGH therapy, and recommend this intervention to reduce the gap between the indication/recommendation of the specialist and patients' behavior.

EFFECT OF NURSE-LED HEALTH EDUCATION ON POST TRAUMATIC STRESS SYMPTOMS AMONG INTERNALLY DISPLACED PERSONS IN JOS, NORTHERN NIGERIA

Introduction: Internal displacement occurred due to armed conflict or other forms of disasters; it was associated with the development of Post-Traumatic Stress (PTS) symptoms. The available interventions for PTS might be costly or not affordable for people in distress in low resource settings; hence, the need to explore alternative options. This study investigates the effect of a nurse-led health education intervention package on PTS symptoms among Internally Displaced Persons (IDPs). We hypothesised that ‘there is no statistically significant difference in PTS symptoms scores among IDPs before and after intervention with nurse-led health education. Methods: A quasi-experimental design was employed for the study. Post-Traumatic Stress short-form scale (PTS-8) was used as an instrument for data collection. Data were analysed using SPSS version 23. The socio-demographics are presented in simple percentages and tables. Unpaired student t-test was used to determine the significant differences among variables of interest in the hypothesis generated. Results: Most common PTS symptoms identified among the IDPs included recurrent memories with means and standard deviations (M 2.92, S.D 0.778); nightmare/sleep disturbance (M 2.26, SD 0.853) and feeling jumpy, easily startled and fearful (M 2.20, SD 0.969). Nurse-led health education caused a reduction in PTS symptoms severity. There was a significant difference in the PTS symptom scores before (2.3±1.7) and after (1.7±0.7) the intervention with a score of 2.37, p=0 .020. Conclusion: The nurse-led health education practised in undeveloped nature modified environment reduced PTS symptoms severity among the IDPs. It should be used as a tool for reducing the symptoms of PTS among IDPs, especially in contexts that are deficient in already developed recreational and traumatic stress healing facilities. KEYWORDS: Posttraumatic stress, Nurse-led health education, internally displaced persons.

Testing a nurse-led, pre-implantation educational intervention for primary prevention implantable cardioverter-defibrillator candidates: a randomized feasibility trial

Implantable cardioverter-defibrillators (ICDs) deliver therapy for life-threatening arrhythmias. Evidence suggests that ICD candidates have misconceptions regarding ICD therapy and unmet information needs. We undertook a pilot feasibility trial comparing a nurse-led educational intervention plus standard care, vs. standard pre-ICD implantation care. Secondary aims included examination of anxiety, quality of life, and shock anxiety. Implantable cardioverter-defibrillator candidates were consented and randomized to standard pre-ICD implantation care vs. standard care plus a nurse-led educational intervention. The primary feasibility outcomes included: recruitment rate, consent rate, randomization rate, proportion of participants able to complete all questionnaires, time to deliver intervention, and intervention topics completion. At baseline, demographic and Patient-Reported Outcomes Measurement Information System (PROMIS) anxiety scores were collected. Four weeks post-ICD implantation, participants completed the PROMIS, Florida Patient Acceptance Survey (FPAS), and Florida Shock Anxiety Scale (FSAS). Twenty patients consented (10 per group). Feasibility targets were achieved for all but two outcomes: consent rate was 87% vs. 95% target, and completion of data collection measures was 85% vs. 90% target. Consent rate was lower than expected as one patient declined, and two could not be approached. Completion rate was lower than expected as two patients were lost to follow-up, and one did not receive an ICD during the study period, leading to incomplete post-implantation survey collections. The results demonstrate the feasibility of conducting a trial comparing a nurse-led pre-implantation educational intervention to standard care in an outpatient setting. Further study to evaluate the effectiveness of this intervention on patient-reported outcomes is warranted.

Experiences of Venous Leg Ulcer persons following an individualised nurse-led education: protocol for a qualitative study using a constructivist grounded theory approach

IntroductionVenous leg ulcers are slow-healing wounds with a high risk of recurrences. To prevent recurrences and promote healing, different nurse-led educational interventions have been developed. The impact of these interventions...

Introducing Nurse-Led Patient Education Visits: Empowering Patients and Elevating Nursing Practice.

The literature includes multiple descriptions of successful nurse-led interventions, but the effects of nurse-led education on nurse and patient satisfaction in an executive health program are unknown. Nursing staff desire to practice more fully within their scope of licensure. Increased practice demands raised questions about whether nurse-led education would improve staff and patient satisfaction. A structured quality improvement process was used to design a nurse-led patient education program. Pilot measures included 5-point Likert scale patient and staff satisfaction surveys. Nurse burnout was also measured before and after the pilot. Patient satisfaction was high; 96% reported favorable satisfaction during the pilot, with sustained results over the following 3 years. Nurses' sense of achievement improved by 12 percentage points, and perception of making good use of skills and abilities increased by 39 percentage points. A nurse-led patient education intervention contributed to improved staff satisfaction while sustaining a positive patient experience.

Nurse-Led Education and Engagement for Diabetes Care in Sub-Saharan Africa: Protocol for a Mixed Methods Study.

BackgroundAs the impact of diabetes grows steeply in sub-Saharan Africa, improvement of the control and treatment of diabetes is a goal that health care systems in sub-Saharan Africa must achieve in the near future. Sub-Saharan Africa faces a number of challenges in addressing the increasing effects of diabetes. One important factor is the shortage of adequately trained health care workers. Diabetes management in sub-Saharan Africa would benefit from innovative approaches that are founded upon solid theoretical constructs, built upon existing human resources and infrastructure, and culturally tailored to the priorities and needs of the local population. Existing resources, such as mobile phones and task-shifting strategies, may be used to assist individuals with glycemic self-management and to facilitate management of additional day-to-day clinical responsibilities.ObjectiveThe objective of the Nurse-Led Education and Engagement Study for Diabetes Care (NEEDS) mixed-methods protocol is to develop a practical, collaborative, effective, and sustainable program for diabetes prevention and management specifically for patients with type 2 diabetes mellitus in sub-Saharan Africa. The protocol aims to improve access to care through task-shifting strategies and the use of mobile health technology.MethodsThis study was designed using a convergent parallel mixed-methods approach that consisted of surveys, key informant interviews, focus group discussions, and focused ethnography. Novel approaches, such as task-shifting strategies and the use of mobile technology, were implemented for type 2 diabetes mellitus health care in sub-Saharan Africa—currently an under-researched area.ResultsData collection began in February 2018, after ethics approval, at the Kwame Nkrumah University of Science and Technology. As of May 2020, participant surveys have been completed (N=100), key informant interviews (n=7) have been completed, and focus groups (5 focus groups; patients, n=18; caregivers, n=6; community leaders, n=2; and faith leaders, n=3) as well as focused ethnographic field observations have been completed. All audio recordings have been transcribed and transcripts of sessions recorded in Twi have been translated to English. Data analysis is currently underway and anticipated completion is in the spring of 2020. Following data analysis, investigators plan to publish study findings.ConclusionsInsights from this study will inform the preliminary development of a feasible and effective nurse-led education and engagement mobile health intervention that has the potential to reduce diabetes-related morbidity, mortality, and burden in sub-Saharan Africa.International Registered Report Identifier (IRRID)DERR1-10.2196/15408

Relationship of Nurse-Led Education Interventions to Liver Transplant Early Readmission.

Early hospital readmission following liver transplantation is associated with lower survival and worse long-term graft function. Language, cultural practices, and health literacy influence patient understanding of posttransplant care education. Complex medication regimes, changes in metabolism and nutrition absorption, and infection/rejection further complicate the prevention of readmission. The purpose of this study was to compare the 30-day readmissions of single-organ liver transplant recipients for 1-year prior and 1-year following the implementation of nurse-led education. The study examined the demographics, clinical characteristics, and 30-day readmissions of 35 liver transplant recipients who participated in the newly designed nurse-led education and 51 liver transplant recipients who experienced the prior post-liver transplant education. A single-center, correlational study with a convenience sample was conducted at a Hispanic-serving South Texas hospital. The new education intervention maintained the standard education and added twice-daily mutual patient-focused goal setting between the nurse and the recipient that aligned with readiness for discharge activities/goals, structured education using abbreviated handouts written at a second-grade level available in both English and Spanish, and the use of repetition through multimodal methods. The odds for 30-day readmissions the year prior to the nurse-led patient education intervention were 2.088 times greater than the year following the implementation. Thirty-day readmissions were reduced by 16.3% from the 2017 cohort to the 2018 cohort. Understanding unique risk factors facilitates structured patient education which can be individualized to the patient and caregiver including collaborative nurse-patient goals.

Effectiveness of nurses-led cardiac rehabilitation program among coronary artery disease patients attending a teaching hospital, Bharatpur

Background: Cardiac rehabilitation (CR) is a comprehensive secondary prevention program, de­livered by multidisciplinary team including nurses. This portion in health care sector is found to be lacking and communication between health care providers and cardiac patients is frequently suboptimal. The aim of this study was to identify the effectiveness of nurse-led cardiac rehabilita­tion program among coronary artery disease patients attending a teaching hospital in Bharatpur, Nepal.&#x0D; Methods: One group pre-test post-test design was used. Total 85 CAD patients were selected for pre and post-test, baseline information was collected using consecutive sampling technique. The educa­tion intervention on CR was developed in Nepali language and distributed to each respondent after pre-test in separate room of OPD of Chitwan medical college and teaching hospital, Bharatpur. After one month of education intervention program, post-test was conducted with same subjects using face to face interview questionnaire using CADE-Q. Data was analyzed using Wilcoxon Rang signed test.&#x0D; Results: Of all 85 respondents, median difference between pre-test was 17 (IQR=14-22) and post-test was 39 (IQR=32-44) which was statistically significant (p=&lt;0.001). The percentage of respondents with non-acceptable level (&lt;50%) of knowledge sharply declined from 96.4% to 11.7% whereas those with acceptable knowledge (≥50%) significantly increased to 3.53% to 88.2% at p value &lt;0.001.&#x0D; Conclusion:The nurse-led educational intervention programme considerably improved the knowl­edge on Cardiac Rehabilitation among CAD patients. Hence, it is strongly recommended that nurses should be involved in establishing and organizing cardiac rehabilitation programs at each tertiary level hospital in Nepal.

EFFECTIVENESS OF NURSES-LED CARDIAC REHABILITATION PROGRAM AMONG CORONARY ARTERY DISEASE PATIENTS ATTENDING A TEACHING HOSPITAL, BHARATPUR

Background: Cardiac rehabilitation (CR) is a comprehensive secondary prevention program, de­livered by multidisciplinary team including nurses. This portion in health care sector is found to be lacking and communication between health care providers and cardiac patients is frequently suboptimal. The aim of this study was to identify the effectiveness of nurse-led cardiac rehabilita­tion program among coronary artery disease patients attending a teaching hospital in Bharatpur, Nepal.&#x0D; Methods: One group pre-test post-test design was used. Total 85 CAD patients were selected for pre and post-test, baseline information was collected using consecutive sampling technique. The educa­tion intervention on CR was developed in Nepali language and distributed to each respondent after pre-test in separate room of OPD of Chitwan medical college and teaching hospital, Bharatpur. After one month of education intervention program, post-test was conducted with same subjects using face to face interview questionnaire using CADE-Q. Data was analyzed using Wilcoxon Rang signed test.&#x0D; Results: Of all 85 respondents, median difference between pre-test was 17 (IQR=14-22) and post-test was 39 (IQR=32-44) which was statistically significant (p=&lt;0.001). The percentage of respondents with non-acceptable level (&lt;50%) of knowledge sharply declined from 96.4% to 11.7% whereas those with acceptable knowledge (≥50%) significantly increased to 3.53% to 88.2% at p value &lt;0.001.&#x0D; Conclusion:The nurse-led educational intervention programme considerably improved the knowl­edge on Cardiac Rehabilitation among CAD patients. Hence, it is strongly recommended that nurses should be involved in establishing and organizing cardiac rehabilitation programs at each tertiary level hospital in Nepal.