الفهرس 
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Abstract
Coronary artery disease is one of most dangerous threats to human health due to its
high incidence and mortality rates. CAD is a term given to heart problems caused by
narrowing or blockage of the coronary arteries which is usually caused by atherosclerosis.
There are many risk factors that increase the probability to develop the disease, some of
them can be modified but others are not. Unhealthy diet, lack of physical activity, smoking,
overweight or obesity, and emotional stress, as well as high blood pressure, high blood
sugar, and high blood cholesterol levels are considered modifiable risk factors can be. On
the other hand, the non- modifiable risk factors can be age, gender, family history, and
race.
The management of coronary artery disease may be medical, surgical or a
combination of both depending on the severity of clinical presentation of the disease, in
addition to modifications of unhealthy life style which include following a healthy dietary
plan, smoking cessation, optimizing body weight, undertaking regular exercise program,
controlling high blood pressure and high blood glucose level, and following stress
reduction techniques, as well as regular follow up in order to improve quality of life.
The nurse has a significant role in assisting patients to deal with their disease through
health teaching about important information regarding the nature of disease process and
treatment modalities, in addition to assessing their lifestyle and then modification of their
unhealthy behaviors regarding CAD.
The present study aimed to
Assess health related knowledge and behaviors among patients with coronary artery
disease.
Materials and Method
Materials
Research design:
A descriptive research design was utilized to accomplish the aim of the present
study.
Setting
The study was conducted in the OutpatientC clinic of Damanhur Medical National
Institute (DMNI), at Beheira governorate.
Subjects:
A convenient sample consisted of 90 adult patients with coronary artery disease
admitted to the above mentioned setting were included in the study who met the following
criteria:
- Adult patients of both genders, age ranging from 20 to 60 years old.
- Has coronary artery disease for at least 6 months and more.
- Patients who are conscious and able to communicate effectively.
- Patients willing to participate in the study.
- Free from associated illness including malignancies, rheumatoid -arthritis, and
hypertensive crisis.
Tools of the study:
Two tools were used to collect the required necessary data in the present study:
Tool one: Health Related Knowledge Among Patients With Coronary Artery
Disease Structured Interview Schedule which included two parts, assessed patients’
socio-demographic characteristics and clinical data, as well as patients’ knowledge related
to nature of coronary artery disease.
Tool two: Health Related Behaviors Among Patients With Coronary Artery
Disease (HRBs-CAD) Structured Interview Schedule to assess health related behaviors
among patients with coronary artery disease related to six parameters including related to
diet habits, compliance with therapeutic drugs, physical activity, smoking habits, and stress
management follow up.
Methods:
The study tools were developed by the researcher after reviewing of recent relevant
literature. The content of constructed tools was revised by a jury of 5 experts in the field of
Medical Surgical Nursing Department of the Faculty of Nursing at Alexandria University
and Faculty of Nursing at Damanhur University to test content validity, completeness, and
clarity of items. Comments and suggestions of jury were considered and the tools were
modified accordingly. A pilot study was conducted on 10% (9 patients) of the study
sample to ascertain the applicability, clarity and feasibility of the developed tools.
Reliability of tools was identified using Cronbach’s Alpha statistical test. The reliability
coefficient value was 0.768 for tool one part two and 0.706 for tool two, in which both are
acceptable.
Data collection:
After securing the administrative approval, the data collection was started and
continued for a period of four months from September 2021to December 2021. A
convenient sample consisted of 90 adult patients with coronary artery disease who met the
inclusion criteria of the subjects were recruited from outpatient cardiac clinic of Damanhur
Medical National Institute (DMNI). Every patient was interviewed individually once by
the researcher to collect the needed data of patients knowledge, and health related
behaviors adopted by patients using the developed tools. Data was collected before or after
meeting the patient with the physician, in morning shift at the waiting area of the clinic,
each interview lasted about 30-45 minutes.
The main results of this study:
The present study showed that more than half of the studied patients (52.2%) were
in the age group of 50- ˂ 60 years, about two thirds (66.7%) of the studied patients
were males, the highest percentage (86.7%) of the studied patients was married,
secondary educated patients formed the half (50%) of the studied patients, and
manual workers represented the highest percent (36.7%).
The present study found that, about two thirds (66.3%) of the studied patients work
between six to ten hours per day, the majority (38.8%) of the nature of their work
was mental & muscular activities, and about two thirds (67.5%) of the studied
patients, their disease condition had an impact on their work.
More than half (57.8%) of the studied patients were living in rural areas, and more
than half (60%) of the studied patients reported that, their monthly income was
insufficient to fulfill the daily requirements.
The present study revealed that chest pain, discomfort in shoulders, arms, neck,
jaw, or back, dyspnea, and heartburn were the most common signs and symptoms
reported by the studied patients with (100%, 84.4%, 78.9%, 45.6% respectively).
The present study revealed that More than half (54.4%) of the studied patients had
bad knowledge level, while 45.6% had fair knowledge level.
The present study illustrated that the majority of the studied patients had fair health
behaviors related to diet habits, compliance with therapeutic drugs, and stress
management (68.9%, 53.3%, and 86.7% respectively). While The majority of the
studied patients had negative health behaviors related to physical activity, smoking
habits, and follow up(72.2%, 90%, 57.8% respectively).
More than half (60%) of the studied patients had negative level of overall health
related behaviors.
The current results showed that statistically significant positive correlation was
found between patients’ knowledge level and age, gender, level of education,
occupation, area of residence, and monthly income (p = 0.026, p=<0.001,
p=<0.001, p = <0.001, p = 0.001, p =<0.001 respectively).
The current results also showed that statistically significant positive correlation
was found patients’ health-related behavior level and age, gender, level of
education, occupation, and monthly income (p = 0.017, p = <0.001, p = <0.001, p =
0.001, p = 0.004 respectively).
The present study showed that a statistically significant positive correlation was
found between overall knowledge level and overall health related behavior scores
of the studied patients with coronary artery disease (p =0.001).
Conclusion
Based on the study findings, it can be concluded that the majority of the studied
patients had bad knowledge level related to nature of coronary artery disease. Moreover, it
can be concluded that the majority of the studied patients had negative level of overall
health related behaviors regarding CAD.
Recommendations
The following were the main recommendations based on the findings of the present
study:
Recommendations for patients:
Development and application of educational sessions for patients to improve their
knowledge about the nature of coronary artery disease.
Illustrated booklets, handouts, and audiovisual materials should be provided for
teaching patients and their families’ healthy behaviors regarding coronary artery
disease.
Recommendations for nurses:
Nurses should receive updated educational sessions about health-related behaviors
regarding coronary artery disease.
Periodic scientific meetings among physicians, nurses, and families must be
conducted to discuss patient’s problems and establish a comprehensive plan for
CAD patients’ needs.
Recommendations for future studies:
Evaluate effect of nursing interventions on health practices’ modifications among
patients with coronary artery disease.
Assessment of factors affecting CAD patient’s compliance with therapeutic
regimen.