{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T11:53:42Z","timestamp":1790855622226,"version":"4.1.0"},"reference-count":52,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,8,14]],"date-time":"2020-08-14T00:00:00Z","timestamp":1597363200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,8,14]],"date-time":"2020-08-14T00:00:00Z","timestamp":1597363200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"the Swedish Heart and Lung Association","award":["E091\/10, E122\/11, E083\/12, E103\/13"],"award-info":[{"award-number":["E091\/10, E122\/11, E083\/12, E103\/13"]}]},{"name":"The County Council Region \u00d6sterg\u00f6tland, Sweden","award":["LIO-92281, 125151, - 27535, - 354951, and 433801"],"award-info":[{"award-number":["LIO-92281, 125151, - 27535, - 354951, and 433801"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Cardiovasc Disord"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cardiac rehabilitation is effective after coronary heart disease (CHD). However, risk factors remain, and patients report fear for recurrence during recovery. Problem-based learning is a pedagogical method, where patients work self-directed in small groups with problem solving of real-life situations to manage CHD risk factors and self-care. We aimed to demonstrate the better effectiveness of problem-based learning over home-sent patient information for evaluating long-term effects of patient empowerment and self-care in patients with CHD. Hypothesis tested: One year of problem-based learning improves patients\u2019 empowerment- and self-efficacy, to change self-care compared to 1\u00a0year of standardised home-sent patient information after CHD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Patients (\n                      <jats:italic>N<\/jats:italic>\n                      \u00a0=\u2009157) from rural and urban areas in Sweden between 2011 and 2015 (78% male; age.\n                    <\/jats:p>\n                    <jats:p>\n                      68\u2009\u00b1\u20098.5\u2009years) with CHD verified by percutaneous coronary intervention (PCI) (70.1%) or coronary artery by-pass surgery (CABG) and CABG+PCI or myocardial infarction (29.9%) were randomly assigned to problem-based learning (experimental group;\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200979) or home-sent patient information (controls;\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200978). The problem-based learning intervention consisted of patient education in primary care by nurses tutoring groups of 6\u20139 patients on 13 occasions over 1\u00a0year. Controls received home-sent patient information on 11 occasions during the study year.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      At one-year follow-up, the primary outcome, patient empowerment, did not significantly differ between the experimental group and controls. We found no significant differences between the groups regarding the secondary outcomes e.g. self-efficacy, although we found significant differences for body mass index (BMI) [\u2212\u20090.17 (SD 1.5) vs. 0.50 (SD 1.6),\n                      <jats:italic>P\u2009=\u20090.033<\/jats:italic>\n                      ], body weight [\u2212\u20090.83 (SD) 4.45 vs. 1.14\u2009kg (SD 4.85),\n                      <jats:italic>P\u2009=\u20090.026<\/jats:italic>\n                      ] and HDL cholesterol [0.1 (SD 0.7) vs. 0.0\u2009mmol\/L (SD 0.3),\n                      <jats:italic>P\u2009=\u20090.038<\/jats:italic>\n                      ] favouring the experimental group compared to controls.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The problem-based learning- and the home-sent patient information interventions had similar results regarding patient empowerment, self-efficacy, and well-being. However, problem-based learning exhibited significant effects on weight loss, BMI, and HDL cholesterol levels, indicating that this intervention positively affected risk factors compared to the home-sent patient information.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>NCT01462799 (February 2020).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12872-020-01647-2","type":"journal-article","created":{"date-parts":[[2020,8,14]],"date-time":"2020-08-14T09:07:05Z","timestamp":1597396025000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["The effect of problem-based learning after coronary heart disease \u2013 a randomised study in primary health care (COR-PRIM)"],"prefix":"10.1186","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2646-8715","authenticated-orcid":false,"given":"Anita K\u00e4rner","family":"K\u00f6hler","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiny","family":"Jaarsma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pia","family":"Tingstr\u00f6m","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Staffan","family":"Nilsson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,8,14]]},"reference":[{"issue":"13","key":"1647_CR1","doi-asserted-by":"crossref","first-page":"1635","DOI":"10.1093\/eurheartj\/ehs092","volume":"33","author":"J Perk","year":"2012","unstructured":"Perk J, De Backer G, Gohlke H, Graham I, Reiner \u017d, Verschuren M, Albus C, Benlian P, Boysen G, Cifkova R, et al. 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