Skip to main content
Top
Published in: Annals of Behavioral Medicine 1/2016

01-02-2016 | Original Article

Using Animation to Improve Recovery from Acute Coronary Syndrome: A Randomized Trial

Authors: Annie Selina Kozlowski Jones, MHealthPsyc, Christopher J. Ellis, MBChB, Martyn Nash, PhD, Brad Stanfield, Elizabeth Broadbent, PhD

Published in: Annals of Behavioral Medicine | Issue 1/2016

Login to get access

Abstract

Background

Recovery from myocardial infarction has been associated with patients’ perceptions of damage to their heart. New technologies offer a way to show patients animations that may foster more accurate perceptions and encourage medication adherence, increased exercise and faster return to activities.

Purpose

The purpose of this study was to investigate the effects of a brief animated intervention delivered at the patients’ bedside on perceptions and recovery in acute coronary syndrome patients.

Methods

Seventy acute coronary syndrome patients were randomly assigned to the intervention or standard care alone. Illness perceptions, medication beliefs and recovery outcomes were measured.

Results

Post-intervention, the intervention group had significantly increased treatment control perceptions and decreased medication harm beliefs and concerns. Seven weeks later, intervention participants had significantly increased treatment control and timeline beliefs, decreased symptoms, lower cardiac avoidance, greater exercise and faster return to normal activities compared to control patients.

Conclusions

A brief animated intervention may be clinically effective for acute coronary syndrome patients (Trial-ID: ACTRN12614000440628).
Literature
1.
go back to reference Steg PG, Goldberg RJ, Gore JM, et al. Baseline characteristics, management practices, and in-hospital outcomes of patients hospitalized with acute coronary syndromes in the Global Registry of Acute Coronary Events (GRACE). Am J Cardiol. 2002; 90: 358-363.CrossRefPubMed Steg PG, Goldberg RJ, Gore JM, et al. Baseline characteristics, management practices, and in-hospital outcomes of patients hospitalized with acute coronary syndromes in the Global Registry of Acute Coronary Events (GRACE). Am J Cardiol. 2002; 90: 358-363.CrossRefPubMed
2.
go back to reference Cooper AF, Jackson G, Weinman J, Horne R. Factors associated with cardiac rehabilitation attendance: A systematic review of the literature. Clin Rehabil. 2002; 16: 541-552.CrossRefPubMed Cooper AF, Jackson G, Weinman J, Horne R. Factors associated with cardiac rehabilitation attendance: A systematic review of the literature. Clin Rehabil. 2002; 16: 541-552.CrossRefPubMed
3.
go back to reference Worcester MUC, Murphy BM, Mee VK, Roberts SB, Goble AJ. Cardiac rehabilitation programmes: Predictors of non-attendance and drop-out. Eur J Cardiov Prev R. 2004; 11: 328-335.CrossRef Worcester MUC, Murphy BM, Mee VK, Roberts SB, Goble AJ. Cardiac rehabilitation programmes: Predictors of non-attendance and drop-out. Eur J Cardiov Prev R. 2004; 11: 328-335.CrossRef
4.
go back to reference Ewart CK, Taylor CB, Reese LB, DeBusk RF. Effects of early postmyocardial infarction exercise testing on self-perception and subsequent physical activity. Am J Cardiol. 1983; 51: 1076-1080.CrossRefPubMed Ewart CK, Taylor CB, Reese LB, DeBusk RF. Effects of early postmyocardial infarction exercise testing on self-perception and subsequent physical activity. Am J Cardiol. 1983; 51: 1076-1080.CrossRefPubMed
5.
go back to reference Frasure-Smith N, Lespérance F. Depression and anxiety as predictors of 2-year cardiac events in patients with stable coronary artery disease. Arch Gen Psychiatr. 2008; 65: 62-71.CrossRefPubMed Frasure-Smith N, Lespérance F. Depression and anxiety as predictors of 2-year cardiac events in patients with stable coronary artery disease. Arch Gen Psychiatr. 2008; 65: 62-71.CrossRefPubMed
6.
go back to reference Rudisch B, Nemeroff CB. Epidemiology of comorbid coronary artery disease and depression. Biol Psychiatr. 2003; 54: 227-240.CrossRef Rudisch B, Nemeroff CB. Epidemiology of comorbid coronary artery disease and depression. Biol Psychiatr. 2003; 54: 227-240.CrossRef
7.
go back to reference Lespérance F, Frasure-Smith N, Talajic M. Major depression before and after myocardial infarction: Its nature and consequences. Psychosom Med. 1996; 58: 99-110.CrossRefPubMed Lespérance F, Frasure-Smith N, Talajic M. Major depression before and after myocardial infarction: Its nature and consequences. Psychosom Med. 1996; 58: 99-110.CrossRefPubMed
9.
go back to reference Riegel BJ. Contributors to cardiac invalidism after acute myocardial infarction. Coronary Artery Dis. 1993; 4: 215-220.CrossRef Riegel BJ. Contributors to cardiac invalidism after acute myocardial infarction. Coronary Artery Dis. 1993; 4: 215-220.CrossRef
10.
11.
go back to reference Mittag O, Kolenda KD, Nordmann KJ, Bernien J, Maurischat C. Return to work after myocardial infarction/coronary artery bypass grafting: Patients’ and physicians’ initial viewpoints and outcome 12 months later. Soc Sci Med. 2001; 52: 1441-1450.CrossRefPubMed Mittag O, Kolenda KD, Nordmann KJ, Bernien J, Maurischat C. Return to work after myocardial infarction/coronary artery bypass grafting: Patients’ and physicians’ initial viewpoints and outcome 12 months later. Soc Sci Med. 2001; 52: 1441-1450.CrossRefPubMed
12.
go back to reference Petrie KJ, Weinman J, Sharpe N, Buckley J. Role of patients’ view of their illness in predicting return to work and functioning after myocardial infarction: longitudinal study. Brit Med J. 1996; 312: 1191-1194.PubMedCentralCrossRefPubMed Petrie KJ, Weinman J, Sharpe N, Buckley J. Role of patients’ view of their illness in predicting return to work and functioning after myocardial infarction: longitudinal study. Brit Med J. 1996; 312: 1191-1194.PubMedCentralCrossRefPubMed
13.
go back to reference Soejima Y, Steptoe A, Nozoe S, Tei C. Psychosocial and clinical factors predicting resumption of work following acute myocardial infarction in Japanese men. Int J Cardiol. 1999; 72: 39-47.CrossRefPubMed Soejima Y, Steptoe A, Nozoe S, Tei C. Psychosocial and clinical factors predicting resumption of work following acute myocardial infarction in Japanese men. Int J Cardiol. 1999; 72: 39-47.CrossRefPubMed
14.
go back to reference Eagle KA, Kline-Rogers E, Goodman SG, et al. Adherence to evidence-based therapies after discharge for acute coronary syndromes: An ongoing prospective, observational study. Am J Med. 2004; 117: 73-81.CrossRefPubMed Eagle KA, Kline-Rogers E, Goodman SG, et al. Adherence to evidence-based therapies after discharge for acute coronary syndromes: An ongoing prospective, observational study. Am J Med. 2004; 117: 73-81.CrossRefPubMed
15.
go back to reference Horwitz RI, Viscoli CM, Donaldson RM, et al. Treatment adherence and risk of death after a myocardial infarction. Lancet. 1990; 336: 542-545.CrossRefPubMed Horwitz RI, Viscoli CM, Donaldson RM, et al. Treatment adherence and risk of death after a myocardial infarction. Lancet. 1990; 336: 542-545.CrossRefPubMed
16.
go back to reference Irvine J, Baker B, Smith J, et al. Poor adherence to placebo or amiodarone therapy predicts mortality: Results from the CAMIAT study. Psychosom Med. 1999; 61: 566-575.CrossRefPubMed Irvine J, Baker B, Smith J, et al. Poor adherence to placebo or amiodarone therapy predicts mortality: Results from the CAMIAT study. Psychosom Med. 1999; 61: 566-575.CrossRefPubMed
17.
go back to reference Redfern J, Hyun K, Chew DP, et al. Prescription of secondary prevention medications, lifestyle advice, and referral to rehabilitation among acute coronary syndrome inpatients: Results from a large prospective audit in Australia and New Zealand. Heart. 2014; 100: 1281-1288.PubMedCentralCrossRefPubMed Redfern J, Hyun K, Chew DP, et al. Prescription of secondary prevention medications, lifestyle advice, and referral to rehabilitation among acute coronary syndrome inpatients: Results from a large prospective audit in Australia and New Zealand. Heart. 2014; 100: 1281-1288.PubMedCentralCrossRefPubMed
18.
go back to reference Leventhal H, Meyer D, Nerenz D. The common sense representation of illness danger. In: Rachman S, ed. Contributions to medical psychology. New York: Pergamon Press; 1980: 7-30. Leventhal H, Meyer D, Nerenz D. The common sense representation of illness danger. In: Rachman S, ed. Contributions to medical psychology. New York: Pergamon Press; 1980: 7-30.
19.
go back to reference Cherrington CC, Moser DK, Lennie TA, Kennedy CW. Illness representation after acute myocardial infarction: Impact on in-hospital recovery. Am J Crit Care. 2004; 13: 136-145.PubMed Cherrington CC, Moser DK, Lennie TA, Kennedy CW. Illness representation after acute myocardial infarction: Impact on in-hospital recovery. Am J Crit Care. 2004; 13: 136-145.PubMed
20.
go back to reference Juergens MC, Seekatz B, Moosdorf RG, Petrie KJ, Rief W. Illness beliefs before cardiac surgery predict disability, quality of life, and depression 3 months later. J Psychosom Res. 2010; 68: 553-560.CrossRefPubMed Juergens MC, Seekatz B, Moosdorf RG, Petrie KJ, Rief W. Illness beliefs before cardiac surgery predict disability, quality of life, and depression 3 months later. J Psychosom Res. 2010; 68: 553-560.CrossRefPubMed
21.
go back to reference Dickens C, McGowan L, Percival C, et al. Negative illness perceptions are associated with new-onset depression following myocardial infarction. Gen Hosp Psychiatr. 2008; 30: 414-420.CrossRef Dickens C, McGowan L, Percival C, et al. Negative illness perceptions are associated with new-onset depression following myocardial infarction. Gen Hosp Psychiatr. 2008; 30: 414-420.CrossRef
22.
go back to reference Ades PA, Huang D, Weaver SO. Cardiac rehabilitation participation predicts lower rehospitalization costs. Am Heart J. 1992; 123: 916-921.CrossRefPubMed Ades PA, Huang D, Weaver SO. Cardiac rehabilitation participation predicts lower rehospitalization costs. Am Heart J. 1992; 123: 916-921.CrossRefPubMed
23.
go back to reference French DP, Cooper A, Weinman J. Illness perceptions predict attendance at cardiac rehabilitation following acute myocardial infarction: A systematic review with meta-analysis. J Psychosom Res. 2006; 61: 757-767.CrossRefPubMed French DP, Cooper A, Weinman J. Illness perceptions predict attendance at cardiac rehabilitation following acute myocardial infarction: A systematic review with meta-analysis. J Psychosom Res. 2006; 61: 757-767.CrossRefPubMed
24.
go back to reference Horne R, Weinman J. Patients’ beliefs about prescribed medicines and their role in adherence to treatment in chronic physical illness. J Psychosom Res. 1999; 47: 555-567.CrossRefPubMed Horne R, Weinman J. Patients’ beliefs about prescribed medicines and their role in adherence to treatment in chronic physical illness. J Psychosom Res. 1999; 47: 555-567.CrossRefPubMed
25.
go back to reference Broadbent E, Ellis CJ, Thomas J, Gamble G, Petrie KJ. Can an illness perception intervention reduce illness anxiety in spouses of myocardial infarction patients? A randomized controlled trial. J Psychosom Res. 2009; 67: 11-15.CrossRefPubMed Broadbent E, Ellis CJ, Thomas J, Gamble G, Petrie KJ. Can an illness perception intervention reduce illness anxiety in spouses of myocardial infarction patients? A randomized controlled trial. J Psychosom Res. 2009; 67: 11-15.CrossRefPubMed
26.
go back to reference Broadbent E, Ellis CJ, Thomas J, Gamble G, Petrie KJ. Further development of an illness perception intervention for myocardial infarction patients: A randomized controlled trial. J Psychosom Res. 2009; 67: 17-23.CrossRefPubMed Broadbent E, Ellis CJ, Thomas J, Gamble G, Petrie KJ. Further development of an illness perception intervention for myocardial infarction patients: A randomized controlled trial. J Psychosom Res. 2009; 67: 17-23.CrossRefPubMed
27.
go back to reference Petrie KJ, Cameron LD, Ellis CJ, Buick D, Weinman J. Changing illness perceptions after myocardial infarction: An early intervention randomized controlled trial. Psychosom Med. 2002; 64: 580-586.CrossRefPubMed Petrie KJ, Cameron LD, Ellis CJ, Buick D, Weinman J. Changing illness perceptions after myocardial infarction: An early intervention randomized controlled trial. Psychosom Med. 2002; 64: 580-586.CrossRefPubMed
28.
go back to reference Williams B, Anderson AS, Barton K, McGhee J. Can theory be embedded in visual interventions to promote self-management? A proposed model and worked example. Int J Nurs Stud. 2012; 49: 1598-1609.CrossRefPubMed Williams B, Anderson AS, Barton K, McGhee J. Can theory be embedded in visual interventions to promote self-management? A proposed model and worked example. Int J Nurs Stud. 2012; 49: 1598-1609.CrossRefPubMed
29.
go back to reference Devcich DA, Ellis CJ, Broadbent E, Gamble G, Petrie KJ. The psychological impact of test results following diagnostic coronary CT angiography. Health Psychol. 2012; 31: 738-744.CrossRefPubMed Devcich DA, Ellis CJ, Broadbent E, Gamble G, Petrie KJ. The psychological impact of test results following diagnostic coronary CT angiography. Health Psychol. 2012; 31: 738-744.CrossRefPubMed
30.
go back to reference Devcich DA, Ellis CJ, Gamble G, Petrie KJ. Psychological responses to cardiac diagnosis: Changes in illness representations immediately following coronary angiography. J Psychosom Res. 2008; 65: 553-556.CrossRefPubMed Devcich DA, Ellis CJ, Gamble G, Petrie KJ. Psychological responses to cardiac diagnosis: Changes in illness representations immediately following coronary angiography. J Psychosom Res. 2008; 65: 553-556.CrossRefPubMed
31.
go back to reference Karamanidou C, Weinman J, Horne R. Improving haemodialysis patients’ understanding of phosphate-binding medication: A pilot study of a psycho-educational intervention designed to change patients’ perceptions of the problem and treatment. Brit J Health Psych. 2008; 13: 205-214.CrossRef Karamanidou C, Weinman J, Horne R. Improving haemodialysis patients’ understanding of phosphate-binding medication: A pilot study of a psycho-educational intervention designed to change patients’ perceptions of the problem and treatment. Brit J Health Psych. 2008; 13: 205-214.CrossRef
32.
go back to reference Perera AI, Thomas MG, Moore JO, Faasse K, Petrie KJ. Effect of a smartphone application incorporating personalized health-related imagery on adherence to antiretroviral therapy: A randomized clinical trial. Aids Patient Care ST. 2014; 28: 579-586.CrossRef Perera AI, Thomas MG, Moore JO, Faasse K, Petrie KJ. Effect of a smartphone application incorporating personalized health-related imagery on adherence to antiretroviral therapy: A randomized clinical trial. Aids Patient Care ST. 2014; 28: 579-586.CrossRef
33.
go back to reference Faul F, Erdfelder E, Lang A, Buchner A. G* Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007; 39: 175-191.CrossRefPubMed Faul F, Erdfelder E, Lang A, Buchner A. G* Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007; 39: 175-191.CrossRefPubMed
34.
go back to reference Nash MP, Hunter PJ. Computational mechanics of the heart. J Elasticity. 2000; 61: 113-141.CrossRef Nash MP, Hunter PJ. Computational mechanics of the heart. J Elasticity. 2000; 61: 113-141.CrossRef
35.
go back to reference Broadbent E, Petrie KJ, Main J, Weinman J. The brief illness perception questionnaire. J Psychosom Res. 2006; 60: 631-637.CrossRefPubMed Broadbent E, Petrie KJ, Main J, Weinman J. The brief illness perception questionnaire. J Psychosom Res. 2006; 60: 631-637.CrossRefPubMed
36.
37.
go back to reference Petrie KJ, Broadbent E, Kydd R. Illness perceptions in mental health: Issues and potential applications. J Ment Health. 2008; 17: 559-564.CrossRef Petrie KJ, Broadbent E, Kydd R. Illness perceptions in mental health: Issues and potential applications. J Ment Health. 2008; 17: 559-564.CrossRef
38.
go back to reference Broadbent E, Petrie KJ, Ellis CJ, Ying J, Gamble G. A picture of health—myocardial infarction patients’ drawings of their hearts and subsequent disability: A longitudinal study. J Psychosom Res. 2004; 57: 583-587.CrossRefPubMed Broadbent E, Petrie KJ, Ellis CJ, Ying J, Gamble G. A picture of health—myocardial infarction patients’ drawings of their hearts and subsequent disability: A longitudinal study. J Psychosom Res. 2004; 57: 583-587.CrossRefPubMed
39.
go back to reference Horne R, Weinman J, Hankins M. The beliefs about medicines questionnaire: The development and evaluation of a new method for assessing the cognitive representation of medication. Psychol Health. 1999; 14: 1-24.CrossRef Horne R, Weinman J, Hankins M. The beliefs about medicines questionnaire: The development and evaluation of a new method for assessing the cognitive representation of medication. Psychol Health. 1999; 14: 1-24.CrossRef
40.
go back to reference Eifert GH, Thompson RN, Zvolensky MJ, et al. The cardiac anxiety questionnaire: Development and preliminary validity. Behav Res Ther. 2000; 38: 1039-1053.CrossRefPubMed Eifert GH, Thompson RN, Zvolensky MJ, et al. The cardiac anxiety questionnaire: Development and preliminary validity. Behav Res Ther. 2000; 38: 1039-1053.CrossRefPubMed
41.
go back to reference Horne R, Weinman J. Self-regulation and self-management in asthma: Exploring the role of illness perceptions and treatment beliefs in explaining non-adherence to preventer medication. Psychol Health. 2002; 17: 17-32.CrossRef Horne R, Weinman J. Self-regulation and self-management in asthma: Exploring the role of illness perceptions and treatment beliefs in explaining non-adherence to preventer medication. Psychol Health. 2002; 17: 17-32.CrossRef
42.
go back to reference Rand CS, Wise RA. Measuring adherence to asthma medication regimens. Am J Resp Crit Care. 1994; 149: 69-76.CrossRef Rand CS, Wise RA. Measuring adherence to asthma medication regimens. Am J Resp Crit Care. 1994; 149: 69-76.CrossRef
43.
go back to reference Kravitz RL, Hays RD, Sherbourne C, et al. Recall of recommendations and adherence to advice among patients with chronic medical conditions. Arch Intern Med. 1993; 153: 1869-1878.CrossRefPubMed Kravitz RL, Hays RD, Sherbourne C, et al. Recall of recommendations and adherence to advice among patients with chronic medical conditions. Arch Intern Med. 1993; 153: 1869-1878.CrossRefPubMed
44.
go back to reference Broadbent E, Ellis CJ, Gamble G, Petrie KJ. Changes in patient drawings of the heart identify slow recovery after myocardial infarction. Psychosom Med. 2006; 68: 910-913.CrossRefPubMed Broadbent E, Ellis CJ, Gamble G, Petrie KJ. Changes in patient drawings of the heart identify slow recovery after myocardial infarction. Psychosom Med. 2006; 68: 910-913.CrossRefPubMed
45.
47.
go back to reference Benner JS, Pollack MF, Smith TW, Bullano MF, Willey VJ, Williams SA. Association between short-term effectiveness of statins and long-term adherence to lipid-lowering therapy. Am J Health-Syst Ph. 2005; 62: 1468-1475.CrossRef Benner JS, Pollack MF, Smith TW, Bullano MF, Willey VJ, Williams SA. Association between short-term effectiveness of statins and long-term adherence to lipid-lowering therapy. Am J Health-Syst Ph. 2005; 62: 1468-1475.CrossRef
48.
go back to reference Kaptein AA, Zandstra T, Scharloo M, et al. ‘A time bomb ticking in my head’: Drawings of inner ears by patients with vestibular schwannoma. Clin Otolaryngol. 2011; 36: 183-184.CrossRefPubMed Kaptein AA, Zandstra T, Scharloo M, et al. ‘A time bomb ticking in my head’: Drawings of inner ears by patients with vestibular schwannoma. Clin Otolaryngol. 2011; 36: 183-184.CrossRefPubMed
49.
go back to reference Ramondt S, Tiemensma J, Cameron LD, Broadbent E, Kaptein AA. Patients’ drawings of blood cells reveal patients’ perception of sickle cell disease. Psychol Health. 2013; 28: 139-140.CrossRef Ramondt S, Tiemensma J, Cameron LD, Broadbent E, Kaptein AA. Patients’ drawings of blood cells reveal patients’ perception of sickle cell disease. Psychol Health. 2013; 28: 139-140.CrossRef
50.
go back to reference Reynolds L, Broadbent E, Ellis CJ, Gamble G, Petrie KJ. Patients’ drawings illustrate psychological and functional status in heart failure. J Psychosom Res. 2007; 63: 525-532.CrossRefPubMed Reynolds L, Broadbent E, Ellis CJ, Gamble G, Petrie KJ. Patients’ drawings illustrate psychological and functional status in heart failure. J Psychosom Res. 2007; 63: 525-532.CrossRefPubMed
51.
go back to reference Tiemensma J, Daskalakis NP, van der Veen EM, et al. Drawings reflect a new dimension of the psychological impact of long-term remission of Cushing’s syndrome. J Clin Endocr Metab. 2012; 97: 3123-3131.CrossRefPubMed Tiemensma J, Daskalakis NP, van der Veen EM, et al. Drawings reflect a new dimension of the psychological impact of long-term remission of Cushing’s syndrome. J Clin Endocr Metab. 2012; 97: 3123-3131.CrossRefPubMed
Metadata
Title
Using Animation to Improve Recovery from Acute Coronary Syndrome: A Randomized Trial
Authors
Annie Selina Kozlowski Jones, MHealthPsyc
Christopher J. Ellis, MBChB
Martyn Nash, PhD
Brad Stanfield
Elizabeth Broadbent, PhD
Publication date
01-02-2016
Publisher
Springer US
Published in
Annals of Behavioral Medicine / Issue 1/2016
Print ISSN: 0883-6612
Electronic ISSN: 1532-4796
DOI
https://doi.org/10.1007/s12160-015-9736-x

Other articles of this Issue 1/2016

Annals of Behavioral Medicine 1/2016 Go to the issue