The Effect of a 5A Model-Based Self-Management Program on Illness Perception in Patients with Myocardial Infarction: A Quasi-Experimental Study

Soleimanian, Mohammad; Jouzi, Mina; Amini, Raziyeh

doi:10.48307/FMSJ.2026.30.4.415

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Volume 30, Issue 4 (Bimonthly 2026)

Feyz Med Sci J 2026, 30(4): 415-424

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The Effect of a 5A Model-Based Self-Management Program on Illness Perception in Patients with Myocardial Infarction: A Quasi-Experimental Study

Mohammad Soleimanian

, Mina Jouzi ^*

, Raziyeh Amini

Department of Nursing, Nursing and Midwifery Sciences Development Research Center, Na.C., Islamic Azad University, Najafabad, Iran , mina.jouzi@iau.ac.ir

Abstract: (195 Views)

Background and Aim: Cardiovascular diseases (CVDs) remain the leading cause of mortality worldwide. Patients’ illness perceptions, reflecting their cognitive and emotional views of their health status, play an important role in self-care behaviors. This study aimed to determine the effectiveness of a 5A model-based self-management program on illness perception in patients with myocardial infarction (MI).
Methods: This quasi-experimental study with a pretest-posttest and control group design was conducted in 2025 in the Cardiology Department of Hajar Hospital, Shahrekord. Forty-eight eligible patients were recruited through convenience sampling and randomly allocated to intervention and control groups (24 per group). The questionnaire assessor was blinded to group allocation. The intervention group received a three-month educational protocol based on the 5A model (assessment, advice, agreement, assistance, and arrangement) through face-to-face sessions and weekly telephone contacts, while the control group received standard care. Data were collected using a demographic questionnaire and the Brief Illness Perception Questionnaire and analyzed using independent and paired t-tests, analysis of covariance, repeated-measures analysis of variance, and the Bonferroni test.
Results: All participants completed the study with no missing data. The groups were homogeneous in demographic characteristics and baseline illness perception scores (P>0.05). After the intervention, the illness perception score was significantly lower in the intervention group (25.41±6.28) than in the control group (41.90±5.85) (P<0.001, Cohen’s d=2.72). ANCOVA confirmed a significant intervention effect (F=45.23, P<0.001, partial eta squared=0.49). A significant time-by-group interaction was also observed (F=38.67, P<0.001). The greatest improvements were observed in personal control, treatment control, and cognitive coherence. No significant correlations were found between age or educational level and reduction in illness perception. Bootstrap sensitivity analysis with 1,000 iterations confirmed the stability of the findings.
Conclusion: A 5A model-based self-management program improves illness perception in patients with MI by correcting misconceptions, reducing uncertainty, and strengthening personal control. Given its low-cost and structured nature, this model may be considered for nursing educational protocols to promote secondary prevention and improve the quality of life of patients with CVDs.

Keywords: Self-management, 5A model, Illness perception, Myocardial infarction, Nursing, Secondary preventiotion

Full-Text [PDF 783 kb] (32 Downloads)

Type of Study: Research | Subject: medicine, paraclinic
Received: 2026/06/5 | Revised: 2026/10/6 | Accepted: 2026/09/23 | Published: 2026/10/4

References

1. World Health Organization. Cardiovascular diseases (CVDs) fact sheet. Geneva: World Health Organization; 2024.

2. Organization of Civil Registration of Iran. Mortality statistics year 2023. Tehran: Organization of Civil Registration of Iran; 2024.

3. Ministry of Health and Medical Education. Prevalence report of cardiovascular diseases. Tehran: Ministry of Health and Medical Education; 2023.

4. Townsend N, Kazakiewicz D, Lucy Wright F, Timmis A, Huculeci R, Torbica A, et al. Epidemiology of cardiovascular disease in Europe. Nat Rev Cardiol. 2022;19(2):133-42. doi:10.1038/s41569-021-00607-3 PMid:34497402

5. Pert J, Thompson DR. Recovery after myocardial infarction: the role of the spouse. Eur J Cardiovasc Nurs. 2002;1(2):89-98.

6. Vahedian-Azimi A, Alhani F, Goharimogaddam K, Kazemnejad A. Effect of family-centered empowerment model on the quality of life in patients with myocardial infarction: a clinical trial study. J Nurs Educ. 2015;4:8-21.

7. Omidi A, Soltanian A, Esmaili MM. The effect of health-related lifestyle self-management intervention on health promotion behaviors in patients with ischemic heart disease. Avicenna J Nurs Midwifery Care. 2016; 24:174-83. doi:10.21859/nmj-24035

8. Barlow J, Wright C, Sheasby J, Turner A, Hainsworth J. Self-management approaches for people with chronic conditions: a review. Patient Educ Couns. 2002;48(2):177-87. doi:10.1016/S0738-3991(02)00032-0 PMid:12401421

9. Bodenheimer T, Lorig K, Holman H, Grumbach K. Patient self-management of chronic disease in primary care. JAMA. 2002;288(19):2469-75. doi:10.1001/jama.288.19.2469 PMid:12435261 PMCid:PMC6549848

10. Leventhal H, Phillips LA, Burns E. The Common-Sense Model of Self-Regulation (CSM): a dynamic framework for understanding illness perceptions. Psychol Health. 2016;21(2):135-42.

11. Broadbent E, Wilkes C, Koschwanez H, Weinman J, Petrie KJ, Broadbent J. A systematic review and meta-analysis of the Brief Illness Perception Questionnaire. Psychol Health. 2015;30(11):1361-85. doi:10.1080/08870446.2015.1070851 PMid:26181764

12. Pouresmaeel Niyazi M, Farshbaf Mani Sefat F, Khademi A, Meshgi S. The mediating role of coping strategies in relationship between illness perception and perceived social support with treatment adherence in cardiovascular patients. Iran J Psychiatr Nurs. 2022;9:98-108.

13. Glasgow RE, Davis CL, Funnell MM, Beck A. Implementing practical interventions to support chronic illness self-management. Jt Comm J Qual Saf. 2003;29(11):563-74. doi:10.1016/S1549-3741(03)29067-5 PMid:14619349

14. Whitlock EP, Orleans CT, Pender N, Allan J. Evaluating primary care behavioral counseling interventions: an evidence-based approach. Am J Prev Med. 2002;22(4):267-84. doi:10.1016/S0749-3797(02)00415-4 PMid:11988383

15. Cochran WG. Sampling techniques. 3rd ed. New York: John Wiley & Sons; 1977.

16. Broadbent E, Petrie KJ, Main J, Weinman J. The Brief Illness Perception Questionnaire. J Psychosom Res. 2006;60(6):631-7. doi:10.1016/j.jpsychores.2005.10.020 PMid:16731240 PMCid:PMC11556873

17. Moss-Morris R, Weinman J, Petrie K, Horne R, Cameron L, Buick D. The Revised Illness Perception Questionnaire (IPQ-R). Psychol Health. 2002;17(1):1-16. doi:10.1080/08870440290001494

18. Masaeli N, Bagherian R, Kheirabadi G, Khedri A, Mahaki B. Psychometric properties of the Persian version of the Brief Illness Perception Questionnaire in chronic diseases. J Res Rehabil Sci. 2018;14(6):332-7.

19. Karimi-Ghasemabad S, Akhbari B, Saeedi A, Talebian Moghaddam S, Nakhostin Ansari N. The Persian Brief Illness Perception Questionnaire: validation in patients with chronic nonspecific low back pain. ScientificWorldJournal. 2021;2021:3348011. doi:10.1155/2021/3348011 PMid:34354548 PMCid:PMC8331304

20. Seydi M, Akhbari B, Ghasem Abad SK, Jaberzadeh S, Saeedi A, Ashrafi A, et al. Psychometric properties of the Persian version of the Brief Illness Perception Questionnaire in Iranian patients with nonspecific chronic neck pain. J Bodyw Mov Ther. 2021;28:323- doi:10.1016/j.jbmt.2021.06.002 PMid:34776159

21. Bahrami M, Salehi S. The effect of the implementation of the self-management program based on the 5A model on the care burden of family caregivers [dissertation]. Shahrekord: Shahrekord University of Medical Sciences; 2022.

22. Lorig KR, Holman HR. Self-management education: history, definition, outcomes, and mechanisms. Ann Behav Med. 2003;26(1):1-7. doi:10.1207/S15324796ABM2601_01 PMid:12867348 PMCid:PMC9790538

23. Webster R, Norman P, Goodacre S, Thompson AR, McEachan RR. Illness representations, psychological distress and non-cardiac chest pain in patients attending an emergency department. Psychol Health. 2014;29(11):1265-82. doi: 10.1080/08870446.2014.923885. PMID: 24831735; PMCID: PMC4192860.

24. Goodman H, Firouzi A, Banya W, Lau-Walker M, Cowie MR. Illness perception, self-care behaviour and quality of life of heart failure patients: a longitudinal questionnaire survey. Int J Nurs Stud. 2013;50(7):945-53. doi: 10.1016/j.ijnurstu.2012.11.007. PMID: 23211796.

25. Keivan S, Shariati A, Miladinia M, Haghighizadeh MH. Role of self-management program based on 5A nursing model in quality of life among patients undergoing hemodialysis: a Randomized Clinical Trial. BMC Nephrol. 2023 Mar 15;24(1):58. doi:10.1186/s12882-023-03108-2. PMID: 36922765; PMCID: PMC10017059.

26. Asgharian F, Bakhshi M, Ranjbar H, Aghebati N. The effect of selfmanagement program based on 5A model on self-care and quality of life in hypertensive elderly patients: a randomized control trial. Journal of Torbat Heydariyeh University of Medical Sciences. 2022;10(1):28-47.

27. Tabiban S, Soleimani MA, Bakhshandeh H, Asghary M. Effect of self-care education on the illness perception in patients with hemodialysis. Avicenna J Nurs Midwifery Care. 2019;27:73-81. doi:10.30699/sjhnmf.27.2.73

28. Salehi M, Bahrami Z. Effect of self-care education based on the 5A model on illness perception in patients with colorectal and lung cancers. J Res Med Sci. 2022;22(5):345-56.

29. Steca P, Greco A, Monzani D, Politi A, Gestra R, Ferrari G, et al. How does illness severity influence depression, health satisfaction and life satisfaction in patients with cardiovascular disease? Psychol Health. 2013;28(7):765-83. doi:10.1080/08870446.2012.759223 PMid:23343116

30. Lorig KR, Ritter P. Disease management: a systematic review of the literature. Patient Educ Couns. 2001;45(3):185-93.

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Soleimanian M, Jouzi M, Amini R. The Effect of a 5A Model-Based Self-Management Program on Illness Perception in Patients with Myocardial Infarction: A Quasi-Experimental Study. Feyz Med Sci J 2026; 30 (4) :415-424
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