Effects of nurse-led home-visit cardiac emergency education on family knowledge and anxiety in Indonesian highland communities: A quasi-experimental study

Abstract

Family members are often the first to recognize signs of cardiac deterioration and respond to emergencies occurring at home. However, inadequate knowledge of cardiac emergencies and anxiety about taking appropriate action may hinder timely recognition and delay emergency responses. In response to this need, the present study examined the effects of a nurse-led home-visit education program on family members’ knowledge and anxiety related to cardiac emergencies. A two-group pretest–post-test quasi-experimental study was conducted in the Nagari Singgalang Public Health Center, Indonesia. To accommodate the geographical characteristics of the study area, eight hamlets were non-randomly allocated as geographical clusters to either the intervention or control group. The groups were maintained separately to minimise the potential for intervention contamination. Of the 106 participants initially enrolled, 93 completed the study, comprising 47 participants in the intervention group and 46 in the control group. Participants in the intervention group received four weekly home-visit education sessions, each lasting 45–60 minutes. The educational program incorporated videos, a learning module, leaflets, scenario-based discussions, and verbal teach-back to reinforce understanding. Meanwhile, participants in the control group received usual care without the additional educational intervention. To evaluate the intervention outcomes, family knowledge and anxiety were assessed at baseline, before the first week of intervention, and at follow-up, 3–7 days after the fourth week. Knowledge was measured using a researcher-developed Cardiac Emergency Knowledge Questionnaire and anxiety was assessed using the Zung Self-Rating Anxiety Scale. Knowledge improvement was greater in the intervention group (difference in mean change=7.88, 95% CI 6.82–8.95; p<0.001), as was anxiety reduction (difference in mean change=−18.11, 95% CI −19.75 to −16.48; p<0.001). Psychomotor cardiac-emergency and CPR (Cardiopulmonary Resuscitation) skills were not assessed. Nurse-led home-visit education improved family knowledge and reduced anxiety over the short term compared with usual care.

Keywords: Anxiety, cardiopulmonary resuscitation, family nursing, health education, house calls