CABIN: A Feasibility Study to Promote Engagement with CR - V1.
Research type
Research Study
Full title
CABIN – (CArdiac Brief INtervention): a feasibility study to promote engagement with cardiac rehabilitation through an early, personalised, and holistic intervention.
IRAS ID
321747
Contact name
Donna Fitzsimons
Contact email
Sponsor organisation
Queen's University Belfast
Clinicaltrials.gov Identifier
Duration of Study in the UK
1 years, 0 months, 1 days
Research summary
Summary of Research
Background
An ST-elevation myocardial infarction (STEMI) is a specific type of heart attack. In a previous study, patients have told us they would like more mental and emotional support after a STEMI. To provide this support, the research team worked with hospital staff and patients to create a brief intervention called CABIN (CArdiac Brief INtervention), which involves a short discussion between a patient and a nurse, along with a leaflet that summarises the information discussed.
Aim
To test if our plan for giving CABIN to patients after a STEMI is suitable, and to explore what impact the intervention may have on mental and emotional well-being, along with knowledge about their condition.
Methods
Forty patients who had a STEMI will be recruited from two hospital centres in Northern Ireland (Royal Victoria Hospital and Ulster Hospital). Participants will be randomly put in a group who receive the full CABIN intervention or a group who receive a shortened version of CABIN. Both groups will receive their respective interventions before leaving the hospital, which will take about twenty minutes. Participants will be asked to complete brief questionnaires before the intervention, after the intervention, 3-4 weeks from diagnosis, and 14 weeks from diagnosis. At the end of the study, patients who took part and staff from the hospitals will be asked to complete an exit interview (patients) or a focus group (staff), which will tell us about their experience of the study / intervention and anything we need to change.
Outcome of Study
If the study is suitable for patients and appropriate for staff to deliver, we will examine the effectiveness of CABIN in a larger study, which may lead to the intervention being used in clinical practice to improve cardiac rehabilitation uptake and outcomes for patients after a STEMI.Summary of Results
Coronary artery disease is a leading cause of death in Northern Ireland and throughout the world. This disease involves a build-up of fatty material or plaque within the main blood vessels (coronary arteries) of the heart, which can cause a heart attack (myocardial infarction) if a blockage occurs. There are around 3,700 hospital admissions each year because of heart attacks in Northern Ireland, which works out at roughly one heart attack every 2 hours. Following a heart attack, many people experience emotional distress (i.e., worried about their health and recovery) and struggle to understand their disease and treatment. These problems can prevent people from attending cardiac rehabilitation following a heart attack, which means they miss out on an important part of their treatment and recovery.To address the problems faced by people after a heart attack, our cardiac research team at Queen’s University Belfast, led by Professor Donna Fitzsimons, worked with patients and cardiology staff to develop CArdiac Brief INtervention (CABIN). CABIN is a conversation (around 20 minutes) between a nurse and a patient before discharge from hospital after a heart attack. The patient also receives an educational leaflet that gives information on what specifically happened to him / her. This support gives patients an education on their disease and provides a safe space for them to discuss any concerns, whilst highlighting the importance of attending cardiac rehabilitation.
After we developed CABIN, funding was received from Northern Ireland, Chest, Heart, and Stroke to test if the intervention was suitable for patients, whilst also evaluating its impact on them. Forty patients who had suffered a heart attack were recruited from Ulster Hospital and Royal Victoria Hospital in Northern Ireland. These patients were randomly put in a group receiving CABIN (intervention; 20 people) or a group who did not (control; 20 people). CABIN was delivered by a member of the research team who was an experienced cardiac nurse. The findings demonstrated that patients were keen to participate in the study and complete all procedures. They also highly rated CABIN and valued the support it provided: “When I was an inpatient… it was not easy… CABIN was like a ray of light… nothing beats the personal touch” (Intervention Group, Participant 19). We also found that patients experienced improvements in disease knowledge; anxiety and depression; and health status and confidence after receiving CABIN. Also, all participants who received CABIN attended cardiac rehabilitation, whereas this attendance rate was lower for the control group (50%).
Overall, our research showed that CABIN was acceptable for patients, and it possibly improves their disease knowledge, emotional wellbeing, and cardiac rehabilitation attendance. Given these positive results, we plan to test the roll-out and impact of CABIN in a larger study across the United Kingdom. This will help us accurately understand how CABIN supports patients, along with identifying how to give this intervention to all people as a normal part of their treatment following a heart attack.
REC name
HSC REC A
REC reference
23/NI/0032
Date of REC Opinion
3 Apr 2023
REC opinion
Further Information Favourable Opinion