A Counselling Intervention to Improve Treatment Adherence of Ischemic Heart Disease Patients: The Development of a Protocol

Abstract

Ischemic Heart Disease (IHD) is classified as one of the world's major cardiovascular diseases and has become the leading cause of deaths in Sri Lanka. Poor treatment adherence plays a significant role in re-hospitalization and death related to IHD. Therefore, a socio-culturally appropriate health counselling intervention was developed for a psychological interventional study to enhance the adherence of prescribed physical activity, diet, and medication among IHD patients attending medical clinics in selected hospitals in Galle district, Sri Lanka. The protocol mainly consisted of two sections (Assessment and Intervention) and six subsections. The intervention method consisted of communication skills, motivational interviewing, goal setting, and problem-solving. An expert panel consisted of a consultant physician, two clinical psychologists, a nurse educator, and a nurse in charge of a health education unit reviewed each subsection on a scale of 0 (total disagreement) to 9 (total agreement) under four aspects in the Delphi review. The ratings in stage one were evaluated and resent for a second round, and the re-ratings were re-evaluated for a degree of consensus. Each subsection was revised or removed if 70% or more of the re-ratings were in categories 0–3 and retained if 70% or more of the re-ratings were in categories 4–6 and 7–9. All the subsections were retained, and few modifications were made as per the expert views. This health counselling intervention protocol is expected to be used in the interventional study among patients with IHD in selected hospitals in Galle district, Sri Lanka.