Effects of a Supportive and Educational Program on Knowledge of Self-Care Behaviors and International Normalized Ratio in Patients Following Surgical Artifical Cardiac Valve Replacement Therapy
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DOI:
https://doi.org/10.64960/srimedj.v41i1.269457Keywords:
supportive and educational program, knowledge, self-care behaviors, international normalized ratio (INR)Abstract
Background and Objectives: Knowledge and preventive behaviors for complications after mechanical valve replacement are important indicators of patient-care outcomes. A supportive and educational program may help improve these outcomes. This study aimed to evaluate the effect of a supportive education program on knowledge, self-care behavior, and coagulation control (international normalized ratio, INR) in patients following mechanical valve replacement.
Methods: This quasi-experimental study used a two-group pre- and post-test design. A total of 54 participants who had undergone mechanical valve replacement for at least 5 years and whose INR was outside the therapeutic range, and who attended the cardiovascular thoracic surgical outpatient clinic at Srinagarind Hospital between September 2024 and July 2025, were enrolled. They were divided into an intervention group (n = 27) and a control group (n = 27). The intervention group received a 12-week supportive education program based on Orem’s self-care theory, while the control group received standard care. Data were collected via questionnaires assessing knowledge and self-care behaviors, and via measurements of INR. Analyses included descriptive statistics and inferential testing with generalized estimating equations (GEEs) and Bonferroni-adjusted multiple comparisons.
Results: The intervention group achieved significantly higher mean knowledge scores than baseline and the control group (mean difference = 4.33; 95% CI: 3.17-5.50; p < 0.001). Their self-care behaviors mean difference was 3.33 (95% CI: 1.49-5.18; p < 0.001) compared with baseline; however, the difference versus the control group was not statistically significant. In addition, 55.56% of the intervention group achieved INR values within the therapeutic range, compared with the control group, though this difference was not statistically significant (p = 0.655).
Conclusion: A supportive and educational program for self-care significantly increased knowledge and improved self-care behavior; it also increased the proportion of patients whose INR returned to the therapeutic range, although this latter improvement did not reach statistical significance.
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