coronary heart disease
health education
quality of life

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Nuraeni, A., Mirwanti, R., & Anna, A. (2019). EFFECT OF A WORKBOOK IN HEALTH EDUCATION ON SELF-EFFICACY AND QUALITY OF LIFE OF PATIENTS WITH CORONARY HEART DISEASE. Belitung Nursing Journal, 5(6), 218–224. https://doi.org/10.33546/bnj.801
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Background: Coronary Heart Disease (CHD) has a high recurrence in Indonesia. This condition may occur as a result of the failure of compliance with post-acute management following a heart attack by CHD patients. One of the causes is the lack of effective health education.

Objective: The aim of this study was to identify the feasibility of the workbook in improving patients’ self-efficacy (SE) and quality of life (QoL).

Methods: This research used a quasi-experimental with pretest-posttest control design. A pretest was done to the patients who were treated in the cardiac intensive unit, and a posttest was carried out at the end of the first and second month after the pretest. The population was all post-acute CHD patients who were admitted to the cardiac intensive unit in one of the referral hospitals in West Java, Indonesia. A purposive sampling was used and obtained 39 respondents who were divided into control and intervention groups. The intervention group was given a health education using a workbook, and the control group was given a direct health education. Self-efficacy was measured using a questionnaire developed by the authors, with high validity and reliability. A SF-12 instrument was used for measuring the quality of life.  Data were analyzed using a descriptive quantitative analysis such as mean, Mann Whitney test, and Independent t-test. To estimate the effects of the intervention to QoL and SE, Kruskal Wallis test and One-way ANOVA were used.

Results: The results showed that there was an increase in SE and QoL in both groups, either in the posttest 1 or posttest 2. The comparison of QoL in the pretest, posttest I and II obtained p=.452, .741, and .826, while SE between and within groups obtained p = .732, .220, and .009, respectively.

Conclusions: Health education using the workbook was significantly more effective to increase SE than QoL of the CHD patients.



Copyright (c) 2019 Aan Nur’aeni, Ristina Mirwanti, Anastasia Anna

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Ahn, S., Song, R., & Choi, S. W. (2016). Effects of self-care health behaviors on quality of life mediated by cardiovascular risk factors among individuals with coronary artery disease: A structural equation modeling approach. Asian Nursing Research, 10(2), 158-163. https://doi.org/10.1016/j.anr.2016.03.004

Alavi, A., Bahrami, M., Zargham-Boroujeni, A., & Yousefy, A. (2015). Pediatric nurses’ perception of factors associated with caring self-efficacy: A qualitative content analysis. Iranian Journal of Nursing and Midwifery Research, 20(2), 232.

American Heart Association. (2015). Highlights of the 2015 American heart association guidelines update for CPR and ECC. Dallas, USA: American Heart Association.

Bandura, A. (1997). Self-efficacy: The exercise of control. New York: W. H. Freeman.

Bandura, A. (2004). Health promotion by social cognitive means. Health Education & Behavior, 31(2), 143-164. https://doi.org/10.1177/1090198104263660

Delima, P. P., Sriati, A., & Nur’aeni, A. (2018). Illness cognition pada pasien dengan penyakit jantung koroner. Journal of Nursing Care, 1(1), 42-49.

Erwinanto, Santoso, A., Putranto, N. E., & Tedjakusuma, P., Suryawan, R., Rifqi, S., & Kasiman, S. (2013). Guidelines for management of hyperlipidemia (1st ed.). Jakarta: Centra Communication.

Gu, G., Zhou, Y., Zhang, Y., & Cui, W. (2016). Increased prevalence of anxiety and depression symptoms in patients with coronary artery disease before and after percutaneous coronary intervention treatment. BMC Psychiatry, 16(1), 259. https://doi.org/10.1186/s12888-016-0972-9

Harun, H. (2013). Faktor-faktor yang berhubungan dengan kepatuhan pasien menjalankan pola hidup sehat pasca IKP [Factors associated with patient compliance in conducting a healthy lifestyle post-PCI]. Universitas Padjadjaran, Retrieved from http://pustaka.unpad.ac.id /wp-content/uploads/2014/01/tesis_hasnia_faktor_yang_ berhubungan_kepatuhan.pdf

Indrawati, L. (2014). Hubungan antara pengetahuan, sikap, persepsi, motivasi, dukungan keluarga dan sumber informasi pasien penyakit jantung koroner dengan tindakan pencegahan sekunder faktor risiko (Studi kasus di RSPAD Gatot Soebroto Jakarta) [Relationship between knowledge, attitudes, perceptions, motivation, family support and patient information sources of coronary heart disease with secondary risk factors (Case study in RSPAD Gatot Soebroto Jakarta)]. Jurnal Ilmiah Widya, 1(1).

Kiki, A., Kalim, H., & Radi, B. (2007). Program penilaian kualitas hidup pasien pasca bedah pintas koroner yang menjalani rehabilitasi fase III [Quality of life evaluation after coronary artery bypass graft surgery in patient who underwent phase III rehabilitation]. Jurnal Kardiologi Indonesia, 28(3), 189-196.

Latimer, A. E., Katulak, N. A., Mowad, L., & Salovey, P. (2005). Motivating cancer prevention and early detection behaviors using psychologically tailored messages. Journal of Health Communication, 10(S1), 137-155. https://doi.org/10.1080/10810730500263364

Miller, T. A., & DiMatteo, M. R. (2016). Health beliefs and patient adherence to treatment. In Howard S Friedman (Ed.), Encyclopedia of mental health (2nd ed., pp. 289-300). Oxford: Elsevier.

National Health Service. (2016). Recovery heart attack. Retrieved from https://www.nhs.uk/conditions/heart-attack/recovery/

National Heart Foundation of Australia. (2013). Recovering from a heart attack. Retrieved from https://www.betterhealth. vic.gov.au/health/ConditionsAndTreatments/recovering-from-a-heart-attack

Nuraeni, A., Mirwanti, R., & Anna, A. (2017). Efektifitas metode pendidikan kesehatan holistik dan berkelanjutan untuk meningkatkan illness cognition dan quality of life pada pasien dengan penyakit jantung koroner [The effectiveness of holistic and continuing health education methods to improve illness cognition and quality of life of patients with coronary heart disease]. Bandung Indonesia: Universitas Padjadjaran.

Nuraeni, A., Mirwanti, R., & Anna, A. (2018). Coronary heart disease patients’ learning needs. Belitung Nursing Journal, 4(3), 287-294. https://doi.org/10.33546/bnj.440

Nuraeni, A., Mirwanti, R., Anna, A., & Prawesti, A. (2016). Faktor yang mempengaruhi kualitas hidup pasien dengan penyakit jantung koroner [Factors affecting the quality of life of patients with coronary heart disease]. Jurnal Keperawatan Padjadjaran, 4(2).

Peterson, J. C., Link, A. R., Jobe, J. B., Winston, G. J., Klimasiewfski, E. M., & Allegrante, J. P. (2014). Developing self-management education in coronary artery disease. Heart & Lung: The Journal of Acute and Critical Care, 43(2), 133-139. https://doi.org/10.1016/j.hrtlng.2013.11.006

Shin, E. S., Hwang, S. Y., Jeong, M. H., & Lee, E. S. (2013). Relationships of factors affecting self-care compliance in acute coronary syndrome patients following percutaneous coronary intervention. Asian Nursing Research, 7(4), 205-211. https://doi.org/10.1016/j.anr.2013.10.003

The Center of Data and Information. (2014). Situasi kesehatan jantung [Situation of cardio health]. Jakarta: Ministry of Health of Indonesia.