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Effectiveness of a 5A Model-Based Self-Management Program on Illness Perception in Patients with Myocardial Infarction
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Mina Jouzi *    |
| , mina.jouzi@iau.ac.ir |
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Abstract: (4 Views) |
Background and Objective: Cardiovascular diseases remain the leading cause of global mortality, with myocardial infarction (MI) being the most prevalent type. Improved survival rates have shifted the focus towards secondary prevention and psychological adaptation. Illness perception, defined as a patient's cognitive and emotional representation of their disease, plays a pivotal role in self-management outcomes. Maladaptive illness perceptions can lead to anxiety, depression, and poor treatment adherence. This study aimed to determine the effectiveness of a self-management program based on the 5A model on illness perception in patients with MI.
Materials and Methods: This semi-experimental study used a two-group pretest-posttest design conducted at Hajar Hospital, Shahrekord, in 2025. The sample consisted of 48 patients (24 per group) recruited via convenient sampling and randomly assigned. The intervention group received a structured self-management program based on the 5A model (Assess, Advise, Agree, Assist, Arrange) over three months, including face-to-face sessions and weekly phone follow-ups. The control group received routine care. Data were collected using the Brief Illness Perception Questionnaire (B-IPQ). Data were analyzed using SPSS v26, employing independent t-tests, paired t-tests, and Analysis of Covariance (ANCOVA) with effect sizes and confidence intervals.
Results: The two groups were homogeneous regarding demographic variables and baseline illness perception scores (P=0.10). Post-intervention analysis revealed a significant reduction in illness perception scores in the intervention group (25.41±6.28) compared to the control group (41.90±5.85) (P<0.001). ANCOVA confirmed the intervention's significant effect on reducing illness perception after adjusting for baseline scores (F=45.23, P<0.001, Partial Eta Squared=0.49). Intragroup analysis showed a significant decrease in the intervention group (P<0.001) and no significant change in the control group (P=0.25). A positive correlation was found between follow-up duration and score reduction (r=0.65, P<0.01).
Conclusion: The 5A model-based self-management program significantly improves illness perception in patients with MI by correcting misconceptions, reducing uncertainty, and enhancing the sense of control. This structured, low-cost intervention can be effectively integrated into nursing protocols for cardiac care to improve psychological outcomes and secondary prevention adherence.
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| Keywords: Self-management, 5A model, Illness perception, Myocardial infarction, Nursing, Secondary prevention |
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Type of Study: Research |
Subject:
medicine, paraclinic
Received: 2026/06/5 | Revised: 2026/09/23 | Accepted: 2026/09/23
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