Abstract
Aim. The aim of this study was to review and analyze the existing evidence regarding the methods, outcomes, and challenges of distance education in nursing for patients with Acute Coronary Syndrome (ACS).
Background. ACS is one of the leading causes of mortality and disability worldwide, and patients face challenges in treatment adherence, lifestyle modification, and psychological management of the disease after discharge. In recent years, nurse-led interventions, particularly utilizing telenursing and communication technologies, have been proposed as novel strategies to improve post-discharge care.
Method. This study was conducted as a systematic review of published research examining nurse-led distance education interventions in patients with ACS. For data collection, the data bases and search engines including PubMed, Scopus, ISI, Google Scholar, and the Iranian Scientific Information Database were searched out over the last ten years (2011 to 2026). The search strategy combined keywords including Distance Education, Nursing Care, Coronary Syndrome, Telenursing, Patient Education, Cardiac Care, Telehealth, and their Persian equivalents. Included studies were randomized controlled trials, quasi-experimental, observational, and qualitative studies. Data were extracted focusing on the type of intervention, follow-up duration, outcomes, and challenges, and were synthesized using thematic analysis. Among 35 identified articles, after removing duplicates (n=5) and irrelevant articles (n=15) through screening of abstracts, 15 articles were selected for final eligibility assessment, and ultimately 11 articles were included in the study. The quality of evidence was assessed using the PRISMA checklist.
Findings. Nurse-led distance education interventions, according to the objectives of the present study, could be categorized into themes including improvement of clinical outcomes and lifestyle modification, enhancement of self-care and self-efficacy, improvement of patient experience and satisfaction, diverse telenursing methods, and executive and procedural barriers and challenges. Furthermore, telenursing education was associated with reductions in cardiovascular risk factors, increased physical activity, improved medication adherence, enhanced self-efficacy, improved quality of life, and increased happiness in patients with ACS.
Conclusion. Telenursing education is considered an effective and feasible approach for improving care and outcomes in patients with ACS. It can lead to improved clinical outcomes and lifestyle modification, while enhancing patient self-care and self-efficacy and increasing their satisfaction. Developing structured and sustainable programs and conducting future research with long-term follow-ups can help strengthen the evidence, effectively integrate these interventions into clinical care, and address executive barriers and challenges. |
