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Person-centred care after acute coronary syndrome, from hospital to primary care - A randomised controlled trial

Journal article
Authors Andreas Fors
Inger Ekman
Charles Taft
Cecilia Björkelund
K. Frid
Maria E H Larsson
Jörgen Thorn
Kerstin Ulin
Axel Wolf
Karl Swedberg
Published in International Journal of Cardiology
Volume 187
Pages 693-699
ISSN 0167-5273
Publication year 2015
Published at Institute of Medicine, School of Public Health and Community Medicine
University of Gothenburg Centre for person-centred care (GPCC)
Institute of Neuroscience and Physiology, Department of Clinical Neuroscience and Rehabilitation
Institute of Health and Care Sciences
Institute of Medicine, Department of Molecular and Clinical Medicine
Pages 693-699
Language en
Links dx.doi.org/10.1016/j.ijcard.2015.03...
Subject categories Clinical Medicine

Abstract

AIM: To evaluate if person-centred care can improve self-efficacy and facilitate return to work or prior activity level in patients after an event of acute coronary syndrome. METHOD: 199 patients with acute coronary syndrome <75years were randomly assigned to person-centred care intervention or treatment as usual and followed for 6months. In the intervention group a person-centred care process was added to treatment as usual, emphasising the patient as a partner in care. Care was co-created in collaboration between patients, physicians, registered nurses and other health care professionals and documented in a health plan. A team-based partnership across three health care levels included transparent knowledge about the disease and medical state to achieve agreed goals during recovery. Main outcome measure was a composite score of changes in general self-efficacy >/=5units, return to work or prior activity level and re-hospitalisation or death. RESULTS: The composite score showed that more patients (22.3%, n=21) improved in the intervention group at 6months compared to the control group (9.5%, n=10) (odds ratio, 2.7; 95% confidence interval: 1.2-6.2; P=0.015). The effect was driven by improved self-efficacy >/=5units in the intervention group. Overall general self-efficacy improved significantly more in the intervention group compared with the control group (P=0.026). There was no difference between groups on re-hospitalisation or death, return to work or prior activity level. CONCLUSION: A person-centred care approach emphasising the partnership between patients and health care professionals throughout the care chain improves general self-efficacy without causing worsening clinical events.

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