Lifestyles, risk factor management and self-care of individuals with coronary heart disease (The KRANS-study)

About the project

Coronary heart disease (CHD) remains the leading cause of death and disability in Europe and is strongly related to lifestyle factors. However, previous European studies show that a large proportion of individuals with CHD do not achieve the recommended lifestyles, risk factor management and therapeutic levels, which can slow or reverse the disease process. It is not known to what extent Icelandic patients achieve standards for secondary prevention. A comprehensive profile of this population, including both clinical data and patient reported outcome measures has not been studied before in Iceland, but is needed to determine where interventions should be targeted.

In this project we aim to describe lifestyle and risk factor management of patients with coronary heart disease (CHD) in Iceland. Patients (N=446) were recruited to the study during hospital admission. Data was collected (2017-2019), during hospital admission and six months later on patients' lifestyle, quality of life, disease-related knowledge, self-care, symptoms of anxiety and depression, risk-factors, health literacy and treatment such as medical treatment, rehabilitation and patient education. Analysis of the data is ongoing.

The project will add to the available evidence on which the European Guidelines on Cardiovascular Disease Prevention in Clinical Practice are based on. The project holds the promise to generate results that will benefit individual patients, the healthcare system, academia and society through suggestions on how to improve individual patient care with education and support, and reconsider the organization and delivery of cardiac care within the healthcare system. Last, but not least, the results will guide the development of new educational interventions to support risk management in rural areas.

Patient recruitment and data collection started in October 2017 and is ongoing. The study has been approved by The Icelandic Ethics committee for medical research ethics (VSNb2017070007/03.01).

Instruments

  • European Health Literacy Survey Questionnaire- short version (HLS-EU-Q16)
  • Coronary artery disease education questionnaire- SV (CADE-Q SV)
  • Self-Care of Coronary Heart Disease Inventory (SC-CHDI)
  • The HeartQoL questionnaire
  • Adapted version of the leisure time physical activity questionnaire (PA questionnaire)
  • Short-Form 12v2 Health Survey (SF-12v2)
  • Hospital Anxiety and Depression Scale (HADS)

Principal investigator

Members

  • Dr. Brynja Ingadóttir, RN PhD, Clinical Nurse Specialist, The National University Hospital of Iceland, Assistant professor, Faculty of Nursing, University of Iceland
  • Dr. Catriona Jennings BA, Faculty of Medicine, NHLI Imperial College London, United Kingdom
  • Auður Ketilsdóttir, RN, MSc, Clinical Nurse Specialist, The National University Hospital of Iceland
  • Inga Valborg Ólafsdóttir, RN, MSc., Clinical Nurse Specialist, The National University Hospital of Iceland and Reykjalundur rehabilitation center
  • Kolbrún Sigurlásdóttir, RN, MSc., Clinical Nurse Specialist, Akureyri Hospital, Akureyri, Iceland
  • Dr. Gunnar Þór Gunnarsson, MD., Head of Cardiology, Akureyri Hospital, Akureyri, Iceland

Participating students

  • Kristín Guðný Sæmundsdóttir, RN BSc, Master student at School of Health Science, University of Akureyri, Iceland
  • Þórunn Björg Jóhannsdóttir, RN BSc, Master student at School of Health Science, University of Akureyri, Iceland

Collaborators

Akureyri Hospital, Akureyri, Iceland.
Landspítali University Hospital, Reykjavik, Iceland.
Faculty of Nursing, University of Iceland, Iceland

Publications

  • Jóhannsdóttir, Th.B., Ingadóttir B. & Svavarsdóttir, M.H. (2021). Rural patients’ experience of education, surveillance, and self-care support after heart disease related hospitalisation: a qualitative study. International Journal of Circumpolar Health 80 (1) Doi: 10.1080/22423982.2021.2007667
  • Svavarsdóttir M.H, Sæmundsdóttir K.G and Ingadóttir, B. (2020). Risk factors and self care of individuals with coronary heart disease: cross sectional study. The Icelandic Journal of Nursing 1(96), 76-83
  • Svavarsdóttir M.H, Sæmundsdóttir K.G and Ingadóttir, B. (2020). Risk factors and self care of individuals with coronary heart disease: cross sectional study. The Icelandic Journal of Nursing 1(96), 76-83

The study was funded by the Icelandic Regional Development Institute; Landspitali University Hospital Research Fund; Akureyri Hospital Research Fund; University of Akureyri Research Fund; Icelandic Nursing Association Research Fund; KEA Research fund and Akureyri Heart Association.