Evaluate the effect of virtual nurse-guided discharge education app on disease knowledge and symptom response in patients following coronary events
Ling Zhang, Robyn Gallagher, Huiyun Du, Tracey Barry, Jonathon Foote, Tiffany Ellis, Aarti Gulyani, Robyn Clark
Abstract
BACKGROUND: Pre-discharge patient education promotes better self-care and secondary prevention following acute coronary syndrome (ACS). Traditional methods do not adapt well to staff and patient time limitations and varied health literacy levels. Self-administered digital methods using engagement strategies may address these issues. OBJECTIVES: To evaluate whether a co-designed, self-administered, virtual nurse avatar-guided patient education app can improve ACS knowledge, beliefs, and medication adherence, and be acceptable for patients and nurses. METHODS: A prospective pre-post-test study was used with patients recruited during hospitalisation for ACS and their associated nursing staff. Patients, alongside usual care, were provided with the education app on a tablet at discharge to use immediately and over the following month. Data were collected immediately following use and one-month post on heart disease knowledge, ACS symptom response attitudes and beliefs and medication adherence. User satisfaction data was collected from both patients and nurses. RESULTS: Participants included nurses (n = 22) and patients (n = 22) who were diagnosed with ST-elevation myocardial infarction (STEMI) (73 %), aged mean 59.7 years and 40 % had not completed high school. Patients' heart disease knowledge improved from pre to one-month post-use (15.7 vs 17.0; p < 0.001) and from immediately post to one-month post-use (16.3 vs 17.0; p = 0.003). Patients' ACS symptom knowledge and response beliefs improved from pre- to immediate post-use (13.8 vs 15.5; p = 0.008; 23.8 vs 25.1; p = 0.038), and to one-month post-use (13.8 vs 17.0; p < 0.001; 23.8 vs 25.7; p = 0.025), and ACS symptom response attitudes improved from pre- to one-month post-use (15.8 vs 17.0; p = 0.036). Patients and nurses rated the app's presentation, content, usability, and usefulness highly; 86% of nurses thought the app would help with discharge education. CONCLUSION: A co-designed, self-administered, virtual nurse avatar-guided education app can improve heart disease knowledge, attitudes, and beliefs following ACS with high nurse and patient acceptability.