Evaluating structured patient education to improve secondary prevention of coronary heart disease and promote health behaviours for Chinese immigrants living in Australia

Abstract

Coronary heart disease (CHD) remains the leading cause of global mortality with a high recurrence rate. However, most of these recurrent cardiac events are preventable through secondary prevention and cardiac rehabilitation programs. Cardiac rehabilitation goals,

including modification of risk factors, adoption of healthy behaviours, and psychosocial wellbeing, can be achieved through patient education. There was a notable gap in patient education that addressed the needs of ethnic minority and immigrant populations. A series of

studies were conducted to address this gap by 1) identifying the most effective patient educational interventions to improve secondary prevention knowledge, health behaviours, and psychological outcomes in patients with CHD; 2) psychometric validating a short version of Coronary Artery Disease Education (CADE-Q SV) for Chinese immigrants with CHD in Australia to assess current needs and determine the impact of patient education; 3) implementing and evaluating a self-administered web-based patient education program for Chinese immigrants with a heart attack.

Our study results demonstrate that the CADE-Q SV has validity and reliability for screening and evaluating CHD-related knowledge in Chinese immigrants. Testing of a self-administered web-based patient education intervention demonstrated significant improvements in CHD knowledge, heart-healthy diet, and self-management behaviours in this population.

This thesis contributes to the understanding of the impact, development and adaptation of structured, theory-based patient education programs and the potential of these programs when self-administered and web-based as a potential solution to meet Chinese immigrants’ needs in terms of secondary prevention of CHD and promoting health behaviours. The patient

education program offers an ideal model for replication in other ethnic monitory and immigrant populations. Future study is suggested for trials in a larger immigrant sample population.