King's College London

Research portal

The effectiveness and experience of self-management following acute coronary syndrome: a review of the literature

Research output: Contribution to journalArticle

Original languageEnglish
Pages (from-to)29-51
JournalInternational Journal of Nursing Studies
Volume61
Early online date24 May 2016
DOIs
Publication statusPublished - Sep 2016

Documents

  • The effectiveness and experience_GUO Accepted 13May2016 GREEN AAM

    The_effectiveness_and_experience_GUO_Accepted_13May2016_GREEN_AAM.pdf, 227 KB, application/pdf

    24/05/2017

    Accepted author manuscript

    CC BY-NC-ND

    © 2016. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/

King's Authors

Abstract

Objectives:
To evaluate the effectiveness of interventions used to support self-management, and to explore patients’ experiences after acute coronary syndrome in relation to self-management.

Design:
Scoping review. Data sources Keyword search of CINAHL Plus, Medline, the Cochrane Library, and PsycINFO databases for studies conducted with adult population and published in English between 1993 and 2014.

Review methods:
From title and abstract review, duplicated articles and obviously irrelevant studies were removed. The full texts of the remaining articles were assessed against the selection criteria. Studies were included if they were original research on 1) effectiveness of self-management interventions among individuals following acute coronary syndrome; or 2) patients’ experience of self-managing recovery from acute coronary syndrome. Results 44 articles (19 quantitative and 25 qualitative) were included. Most studies were conducted in western countries and quantitative studies were UK centric. Self-management interventions tended to be complex and include several components, including education and counselling, goal setting and problem solving skills which were mainly professional-led rather than patient-led. The review demonstrated variation in the effectiveness of self-management interventions in main outcomes assessed - anxiety and depression, quality of life and health behavioural outcomes. For most participants in the qualitative studies, acute coronary syndrome was unexpected and the recovery trajectory was a complex process. Experiences of making adjustment and adopting lifestyle changes following acute coronary syndrome were influenced by subjective life experiences and individual, sociocultural and environmental contexts. Participants’ misunderstandings, misconceptions and confusion about disease processes and management were another influential factor. They emphasised a need for ongoing input and continued support from health professionals in their self-management of rehabilitation and recovery, particularly during the initial recovery period following hospital discharge.

Conclusions:
Evidence of the effectiveness of self-management interventions among people with acute coronary syndrome remains inconclusive. Findings from the patients’ experiences in relation to self-management following acute coronary syndrome provided important insights into what problems patients might have encountered during self-managing recovery and what support they might need, which can be used to inform the development of self-management interventions. Theoretical or conceptual frameworks have been minimally employed in these studies and should be incorporated in future development and evaluation of self-management interventions as a way of ensuring clarity and consistency related to how interventions are conceptualised, operationalised and empirically studied. Further research is needed to evaluate self-management interventions among people following acute coronary syndrome for sustained effect and within different health care contexts.

Download statistics

No data available

View graph of relations

© 2018 King's College London | Strand | London WC2R 2LS | England | United Kingdom | Tel +44 (0)20 7836 5454