Evaluation of the effectiveness of the theory based individual counseling initiative in patients with familial hypercholesterolemia

Objective: The aim of this study is to evaluate the effectiveness of the "Individual Counseling Initiative", which was developed on the basis of the change stages of the "Transteoretic Model" in patients with familial hypercholesterolemia, in terms of lifestyle changes, disease management and clinical parameters. Method: The population of the study, which was planned as a randomized controlled experimental study, consisted of patients who were followed up in the Lipid Polyclinic of Ege University Faculty of Medicine, Department of Cardiology. After the patients were grouped according to educational status and presence of coronary artery disease, simple randomization was performed and intervention and control groups were determined. The study included 120 patients (60 interventions, 60 controls) who met the inclusion criteria. Procedure; the data of the study were collected by using the "Patient Information Form", "Dietary Habits and Daily Dietary Consumption Frequency Diagnosis Form", "International Physical Activity Questionnaire", "Modified Morisky Medication Adherence Scale", "Behavior Change Stage Diagnostics Short Questionnaire," "MacNew Quality of Life Scale", "Self Efficacy Scale", "Structured Phone Interview" and the familial hypercholesterolemia information booklet was distributed to the patients in the intervention group. Data; the data were collected in three stages: first follow-up (week 0), intermediate follow-up (week 12) and final follow-up (week 24). Two of the six individual counseling interviews with the intervention group were conducted as face to face interviews and four of them were conducted as telephone calls. In telephone follow-ups; questions were asked about nutrition, physical activity and treatment adaptation in which behavior change was targeted. Reminder messages were sent by the researcher via sms/e-mail to ensure the desired behavioral changes and increase the motivation. Data were analyzed by using SPSS 21.0 package program. The results were evaluated at 95% confidence interval and p <0.05. Results: 93.3% of the patients in the intervention group and 92.5% of the patients in the control group were heterozygous. Homogenity of distribution is provided between the groups. In the first follow-up, the rate of patients who consumed whole-grain bread in the intervention group increased intermediate follow-up and final follow-up periods and the difference between the follow-up periods was statistically significant. The differences between the egg and saturated fat (solid/animal) consumption frequencies of the patients in the intervention group and the follow-up data of the control group patients were statistically significant. When physical activity and treatment compliance levels of intervention group patients were evaluated according to their follow-up times; There were statistically significant differences in the comparison of intergroup final follow-up data and behavioral change. No statistically significant difference was found between the final follow-up data of the both groups in terms of total quality of life scale scores. However, in the intervention group statistically significant differences were found between some follow-up times in the physical, emotional and social subscales of the quality of life scale scores. Except for the struggling against the obstacles sub dimension, there was no statistically significant difference between the follow-up times in the self efficacy- sufficiency scale sub-dimensions of the patients in the intervention group. According to the smoking status of the patients, the difference between the first follow-up and the final follow-up and intermediate follow-up and the final follow-up period were statistically significant. In the comparison of the difference between the final follow-up clinical parameters of the patients in the intervention and control group; BMI, total cholesterol, LDL-C and triglyceride levels were found to be lower in the intervention group and a statistically significant difference was found between the two groups. A statistically significant difference was found in the comparison of the final follow-up blood pressure values between the groups. Conclusion: It has been identified that the individual counseling initiative on the basis of the transformation stages of the Transteoretic Model is effective in controlling lifestyle changes (nutrition and physical activity) in patients with familial hypercholesterolemia, in treatment compliance, and in control of clinical parameters (BMI, total cholesterol, LDL-C and blood pressure) that are important for the disease.