Coronary Heart Attack Prevention

Intervention Plan Summary

Coronary heart events are potentially lethal conditions. Treatment of atherosclerosis of the heart arteries is expensive and lacks effectiveness if preventive strategies are ignored (Libby, 2013). Thus, prophylactic interventions for coronary heart disease are both effective and compulsory. Risk factors philosophy allows heath caregivers to understand in detail in which direction preventive strategies should proceed. Dietary patterns are among some of the simplest and most effective methods in coronary heart attack prevention. As many as 30% of all myocardial infarctions can be prevented if a healthy diet is followed on a regular basis (Hu, 2008).

Social cognitive nursing theory when applied to the area of coronary heart attack prevention through dietary interventions intends the health caregivers to understand the basic pathophysiological aspects of atherosclerosis with special attention to lipid imbalance and further practical application of this knowledge. The nurse as a major provider of medical aid plays a key role in critical analysis of the current patient’s diet as well as development of alternative diet strategy and maintenance of its adherence.

Constitutive dietary improvements mean detection of unhealthy components and eliminating them from regular meals or at least diminishing their consumption. This is especially true for cholesterol, saturated fats and animal fats. However, this is not enough to avoid unhealthy foods because it is desirable that unsaturated fats, vitamins, antioxidants and fiber are considerably increased. As a result, the nurse assists in developing new dietary patterns, explains why they are important, and organizes classes dedicated to the target audience. Finally, the program must be maintained and evaluated for its effectiveness.

Evaluation Approaches

During a formative evaluation, corrections are implemented while forming the program. As for the current preventive strategy, formative evaluation might include personal reports of the nurses about adherence of their clients to the preventive program, statistics on failures to cooperate, and success to keep adherent to the program. These data help the designer to correct certain aspects of the strategy. For example, if a considerable number of participants fail to maintain the diet, the nurse might seek aid of a professional diet specialist and a psychologist with the project. Should individuals drop the preventive strategy, social workers and mass media can be activated to change social opinion for the better. Summative evaluation is a method of appreciation at the end of the project. Quarterly summaries discussed in the previous part of this coursework are an example of summative evaluation judging. The summarizing observations clearly show how effective the intervention plan is.

Evaluation Plan

Tools

The nurses activated into the coronary attack prevention program regularly report on the status. They may meet with the supervisor every month to discuss personal impressions, general trends, pitfalls and difficulties, sharing experience. This will be treated as a formative evaluation. However, every 3 to 6 months reports will be presented. An Excel sheet would fit the basic requirements for a summative evaluation. This must include the following:

• dietary pattern (No. of meals per day, estimated quantities of saturated fats, unsaturated fats, cholesterol, vitamins, fiber; No. of whole grains, fresh fruit & vegetables per week; fish, healthy oils, nuts)
• coronary events (including angina pectoris)
• body mass index
• blood cholesterol level and lipid profile
• medical examination data (if indicated by the attending physician, such as data from EKG, ECHO, arterial blood pressure, blood sugar level)
• self-evaluation (well-being estimated by the client)

As a result, some data can be shown graphically, while other semi-quantitatively or qualitatively. In the best-case scenario, the client must experience improvement of healthy foods intake and reduction of symptoms or cholesterol.

Process

It must be specially emphasized that effective prevention is a life-long process and the health promotion strategy when started should never end, at least in the ideal scenario. As soon as the target audience is expected to live for more than 30 years additionally, the follow-up process must be kept in an electronic database. The prevention design does not predict any ‘control’ groups and this will compose an important issue for the process of evaluation. We will not be able to compare the results to a population that is on unhealthy diet (unless some people of the target audience deviate from healthy diet remaining in the investigation group). The only way to evaluate the effectiveness of the dietary changes is to control their cholesterol level, monitor blood lipid profile, perform medical examinations and watch for coronary events.

Data Analysis

A comparative data analysis, similar to those reported in modern randomized trials and the Framingham study is troublesome because the comparative group is absent. However, some essentials can be still evaluated. It is crucial to estimate the period when the cholesterol level will come to a satisfactory level and blood lipids normalize. Dynamics of body-mass index is noteworthy. Self-evaluation is interesting to monitor. Finally, the trend towards the development of coronary events can be compared with the general population.

Summary

In conclusion, as soon as the client honestly follows the prevention strategy, its evaluation is expected to see the positive effects of a healthy diet.