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 were recruited to the study during hospital admission. Data was collected (2017-2019), during hospital admission (N=446) and six months later (N=377) 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.

The study was 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

MS thesis from the project

  • Jóhanna Katrín Kristjánsdóttir, University of Akureyri, School of Health, Business and Natural Sciences. Effects of rehabilitation on physical activity and risk factors for coronary heart disease. A cross-sectional study.
  • Bettý Grímsdóttir. University of Akureyri, School of Health Sciences. Health literacy of individuals with Coronary Heart Disease. Descriptive cross-sectional study.
  • Kristín Guðný Sæmundsdóttir. University of Akureyri, School of Health Sciences. Selfcare of individuals with coronary heart disease and their risk for developing diabetes type 2.
  • Kristrún María Björnsdóttir. Reykjavík University. Physical Activity Levels and Glycemic Control Among Adults Living with Coronary Heart Disease.
  • Þórunn Björg Jóhannsdóttir. University of Akureyri, School of Health Sciences. Rural patients’ experience of education, surveillance, and self-care support after heart disease related hospitalization: a qualitative study.

Collaborators

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

Publications

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.