The Relationship Between Self-Efficacy and Functional Capacity Among Discharged Heart Failure Patients in Jordan.

BACKGROUND: Self-efficacy is an important factor associated with healthy lifestyle changes in heart failure treatment. Functional capacity testing of heart failure patients (HFPs) can stratify prognosis. Reduced functional capacities in HFPs are linked to a poor heart failure prognosis. Limited research has examined the potential relationship between self-efficacy and functional capacity. AIM: The aims of this study were to assess self-efficacy level and functional capacity among HFPs after hospitalization, and examine whether there is a relationship between them. METHODS: A descriptive correlational design was used. A convenience sample of 220 HFPs was recruited from 2 hospitals in Jordan. The Arabic version of Cardiac Self-Efficacy Questionnaire was used to assess self-efficacy, the 6-Minute Walking Test (6-MWT) was used to assess functional capacity, and the Borg rating of perceived exertion scale (Borg Scale) was used to assess exertion during 6-MWT. RESULT: The sample included 46.8% male (n = 103) and 53.2% female (n = 117). The mean age was 52.66 ± 8.91 years. Most of the HFPs were categorized based on New York Heart Association classification as class I, 35.9% (n = 79), and class II, 41.4% (n = 91). The mean ejection fraction was 41.46 ± 9.44. The global self-efficacy was moderate (32.98 ± 9.92), and the mean score for the 6-MWT was 494.35 ± 143.37. The Borg Scale mean was 10.94 ± 3.34. In addition, there was a positive relationship between self-efficacy and 6-MWT (r = 0.63, n = 220, P = .01). CONCLUSION: This study provides baseline data for further research on treatment of HFPs, and the development of evidence-based tailored health interventions to maintain and improve self-efficacy and functional capacity among these service users. Moreover, replicated researches can test the study results considering different methodologies, such as using objective functional capacity tool and longer follow-up periods.

Predictors of Post-Percutaneous Coronary Intervention Chest Pain Among Coronary Heart Disease Patients.

Patients who undergo percutaneous coronary intervention (PCI) procedure frequently suffer post-PCI chest pain (PPCP). This study aims to identify the changes in PPCP level and investigate the predictors of PPCP among patients with coronary heart disease at three measurement times: on admission (T1), 24 hours post-PCI (T2), and 30 days post-PCI (T3). A repeated-measure design was used. Significant differences were observed in PPCP levels between T1 and T2; between T2 and T3; and between T1 and T3. The predictors of PPCP are (1) high-intensity physical activities duration per week, (2) cardiac enzyme level upon admission, (3) increased ejection fraction, and (4) increased heart rate. The results highlight that identifying predictors of PPCP helps in determining high-risk patients, whereby evidence-based interventions can decrease readmission rates and reduce patient exposure to unnecessary investigations and procedures. More research is needed to explain the changes in PPCP level and to confirm these results.

Changes in the Anxiety Levels of Patients Undergoing Percutaneous Coronary Intervention.

BACKGROUND: Anxiety is a predictor of a bad prognosis in patients with coronary heart disease. Patients with coronary heart disease undergoing percutaneous coronary intervention (PCI) reported high levels of anxiety, yet little is known about changes in anxiety levels after this procedure. OBJECTIVE: The aim of this study was to examine changes in anxiety levels of patients undergoing PCI and identify differences in anxiety levels based on patients' demographics and clinical details. METHODS: A convenience sample of patients undergoing first-time elective PCI (N = 165) completed the Generalized Anxiety Disorder Scale at baseline (discharge time) and 6 months later. Paired samples t test was used to assess the changes in anxiety levels. The χ2 test was used to examine the pattern of changes between the 2 time points. Patients did not have access to cardiac rehabilitation. RESULTS: Six months after PCI, the anxiety level scores decreased significantly; mean scores for the baseline versus follow-up were 10.84 ± 5.98 versus 4.29 ± 6.02, respectively (P = .001). Only 18.2% of the patients had normal levels of anxiety at the baseline compared with 71.5% 6 months later. History of hospitalization after PCI, being a smoker, younger age, and low level of education were associated with higher levels of anxiety at follow-up. CONCLUSIONS: Although anxiety levels were reduced 6 months after PCI, assessing patients' anxiety levels and implementing psychoeducational interventions at follow-up should be incorporated to optimize the care of PCI patients, particularly for those who are younger, who are smokers, or with a low educational level.

High levels of risk factors and poor secondary prevention for coronary heart disease patients in public hospitals: A descriptive repeated measures study.

BACKGROUND: Secondary prevention is a priority after coronary revascularization for effective long-term cardiovascular care. Coronary Heart Disease is a major health problem in Jordan, but little is known about the current provision of secondary prevention. AIM: The aim of this study was to evaluate risk factors and explore the current provision of secondary Coronary Heart Disease prevention among patients presenting with first-time Coronary Heart Disease at two time points: during hospitalization (Time 1) and 6 months later (Time 2), in multicentre settings in Jordan. METHODS: A descriptive, repeated measures research study design was applied to a consecutive sample of 180 patients with first-time Coronary Heart Disease. Demographic and clinical details were recorded from medical files. Self-administered questionnaires developed by the researchers were used to measure secondary prevention information related to Coronary Heart Disease, including secondary prevention services, lifestyle advice received and medical advice topics. A short form of the International Physical Activity Questionnaire was used to measure physical activity. Participants were assessed at Times 1 and 2. RESULTS: Unstructured lifestyle advice given to the patients at Times 1 and 2 most frequently related to medications, smoking, diet and blood lipids control advice topics, with no statistically significant improvement in cardiovascular risk factors among patients between Times 1 and 2. CONCLUSION: Despite an extremely high prevalence of risk factors in this population, the provision of secondary prevention is poor in Jordan, which requires urgent improvement, and the contribution of nurses' to secondary prevention should be enhanced.

The Impact of Type of Acute Myocardial Infarction on Cardiac Patient Self-efficacy After Hospitalization.

BACKGROUND: Self-efficacy is an important psychological construct associated with patient adherence with healthy lifestyle choices. Few studies have focused on the impacts of the type of acute myocardial infarction (AMI), non-ST-elevation myocardial infarction (STEMI) and STEMI, and the different treatment modalities of AMI on changes in cardiac self-efficacy after hospitalization. OBJECTIVE: This study examined the changes in cardiac self-efficacy based on the type of AMI and aimed to investigate the impact of different treatment modalities on changes in cardiac self-efficacy among post-AMI patients during hospitalization and at the 3- and 6-month follow-ups subsequent to hospitalization. METHODS: A repeated-measures design was used with a convenient sample of 210 patients diagnosed with first AMI. Patients completed the Cardiac Self-efficacy Questionnaire at the 3 time points. The study was implemented in 3 major hospitals in Jordan. Patients did not have access to cardiac rehabilitation. RESULTS: There was a statistically significant impact of AMI type on changes in cardiac self-efficacy measured between T1 and T2, between T2 and T3, and subsequently between T1 and T3. Nevertheless, there was no statistically significant impact of treatment modalities of AMI on changes in cardiac self-efficacy measured at the 3 time points. CONCLUSIONS: Assessment of self-efficacy for post-AMI patients is recommended. Moreover, post-non-STEMI patients need more attention when implementing an intervention to enhance self-efficacy after hospitalization. Health decision makers have to consider establishing cardiac rehabilitation to improve self-efficacy in Jordan. Further research is needed to confirm the study results and to investigate other contributing factors that could influence self-efficacy after hospitalization.

Jordanian Patients' Family Members Need Perceptions in the Critical Care Settings: Nurses' Perspectives versus Family Members' Perspectives in the Context of Health Informatics.

Background: An unexpected hospitalization in any of the Critical Care Units (CCUs) is a stressful condition, not only for patients but also for other family members. Research in this field in Jordan is not available. The main objective of this study was to identify the most important needs as perceived by these family members in the light of this stressful event and compare them with the nurses' perceptions of the importance of these needs and also to determine the perception of the needs' importance with the sociodemographic characteristics of both family members and caring nurses. Methods: This was a cross-sectional study conducted in the period between February and August 2020 among adult family members of patients admitted to the CCUs in hospitals of Jordan from all sectors (public, private, and teaching). The "Critical Care Family Needs Inventory (CCFNI)" questionnaire was administered to 82 family members and 99 CCU nurses to determine the importance of the needs on the inventory. The data were analyzed using descriptive statistics. Results: The most important need identified by the family members was relevant to the need for proximity (3.64 ± 0.45), followed by information (3.57 ± 0.58), assurance (3.44 ± 0.43), support (3.31 ± 0.62), and comfort (3.21 ± 0.56). Nurses identified the needs for assurance as the highest, followed by information, comfort, and support, whereas proximity was the least need perceived as very important. The top 10 important needs for both family members and nurses were identified. Family members and nurses were only common in 2 of the need statements on the scale. There was no significant association between the sociodemographic characteristics of the sample and the perception of the needs' importance (p=0.05). Conclusion: This study has shown that nurses and family members of patients admitted to CCUs have different perspectives relevant to needs' importance. This should warn nurses to set the needs viewed by family members as a priority. Implications. In the CCU settings, in the context of advancing health informatics, families of patients in the ICUs have different needs other than those viewed by nurses. Their needs must be identified and considered.

Predictors of severe postoperative pain after orthopedic surgery in the immediate postoperative period.

AIM: Severe pain in the immediate postoperative period can negatively affect patients' quality of recovery, prolong hospital stay, and increase the risk of developing persistent pain. This study aimed to examine the predictors of severe postoperative pain in the immediate postoperative period among orthopedic trauma patients. METHODS: A prospective observational study design was used. Data were collected from 153 patients that underwent orthopedic surgery procedures. Pain scores were assessed by a numeric pain scale at 45 min in the Post Anesthesia Care Unit. Physical health status was measured by the American Society of Anesthesiologists Status Classification System, and total dose of opioids (converted to morphine equivalents) and other demographic and clinical characteristics were recorded from medical records. RESULTS: Preoperative smoking and physical health status were statistically significant predictors of severe postoperative pain in the immediate postoperative period. The odds of severe postoperative pain for smokers were 2.42 times the odds of nonsmokers. Patients with severe systemic disease showed 4.27 times lower odds of severe pain than more healthy patients. CONCLUSION: Preoperative predictors of severe postoperative pain should be considered when assessing and treating orthopedic patients postoperatively to assure adequate pain relief.

Exercise Self-efficacy, Perceived Benefits, and Barriers to Exercise Among Patients Following Acute Myocardial Infarction.

BACKGROUND: Increasing patient adherence to regular exercise post acute myocardial infarction (AMI) is a major goal after hospitalization. It is therefore essential to identify perceived benefits and barriers to exercise and its association with exercise self-efficacy among patients post AMI. AIMS: The purpose of this study was to identify the perceived benefits and barriers to exercise and the predictors of exercise self-efficacy among patients after AMI. METHODS: A cross-sectional study design was used with a convenience sample of 254 patients, recruited from the 3 main hospitals in Jordan. Instruments included the Exercise Benefits and Barriers Scale and the Exercise Self-Efficacy Scale. Mean scores were computed to determine the perceived benefits and barriers responses. Multiple linear regression was conducted to explore the predictors of exercise self-efficacy. Data were collected over 5 months. RESULTS: The greatest perceived benefits were related to personal factors, for example, "I enjoy exercise" (2.45 [0.98]), and physical performance, for example, "My muscle tone is improved with exercise" (2.44 [0.86]) and "Exercise increases my stamina" (2.43 [0.86]). The greatest perceived barriers were related to environmental barriers, for example, "Lack of exercise places" (2.67 [0.82]), and internal factors related to physical exertion itself, for example, "Concerned about getting tired during exercise participation" (2.65 [0.72]). The Exercise Self-Efficacy Scale showed that patients post ST-elevation AMI had higher exercise self-efficacy than those with other treatment modalities (AMI, 44.71 [19.07] vs 36.59 [17.34]; P = .001). Patients treated by primary percutaneous coronary intervention had higher exercise self-efficacy, 49.2 (18.61), than patients treated by thrombolysis and percutaneous coronary intervention, 39.28 (18.3), and patients treated by medications other than thrombolytic therapy, 36.59 (17.4) (F2,251 = 11.612, P = .001). The multiple linear regression model explained approximately 29% of the variance in exercise self-efficacy (F11,242 = 7.914, P < .001). Five variables contributed significantly to the prediction of self-efficacy: type of AMI (standardized ß = -0.173, t = -3.311, P = .01), perceived exercise benefits (standardized ß = 0.322, t = 4.912, P = .01), perceived exercise barriers (standardized ß = -0.291, t = -4.521, P = .01), being Argela smokers (water pipe smoking) (standardized ß = -0.132, t = -2.617, P = .029), and cholesterol level (standardized ß = -0.158, t = -2.174, P = .003). CONCLUSIONS: Primary perceived benefits of exercise reported were in the areas of personal factors and improved physical performance. The main perceived barriers to exercise were in the areas of environmental factors and physical exertion. Identification of benefits and barriers to exercise, type of AMI, and treatment modalities of AMI as predictors of exercise self-efficacy is a significant step for developing appropriate interventions that effectively improve exercise self-efficacy and exercise among post-AMI patients.

The Association Between Depressive Symptoms and Length of Hospital Stay Following Coronary Artery Bypass Graft is Moderated by Perceived Control.

PURPOSE: Depressive symptoms can negatively influence patient outcomes after coronary artery bypass graft surgery (CABG). Preoperative depressive symptoms can be associated with a longer hospitalization. Perceived control moderates the effect of anxiety on length of stay (LOS) among CABG patients, but its effect on depressive symptoms and LOS is not well studied. This study tests whether perceived control moderates the relationship between depressive symptoms and LOS among patients following CABG. PATIENTS AND METHODS: This prospective cohort study was conducted on 220 participants recruited from three hospitals in Jordan. Participants' depressive symptom levels were measured using the depression subscale of the Hospital Anxiety and Depression Scale. Perceived control was measured by the Arabic version of the Control Attitude Scale-Revised. Length of stay was obtained from medical records. Data were analyzed using multiple regression and simple slope analysis. RESULTS: Females had higher levels of depressive symptoms (mean [SD]: 16.7 [5.2] vs 11.6 [5.6], P<0.05), and longer LOS (mean [SD]: 17.5 [12.7] vs 10.3 [9.0], P<0.001) compared to male patients. Being female increased the length of stay by 0.18 days. Every one-unit increase in preoperative depressive symptoms increased LOS by 0.37 days. Perceived control has a protective effect; every one unit increase in perceived control decreased LOS by 0.28 days. Moreover, perceived control moderates the relationship between depressive symptoms and LOS. CONCLUSION: This study suggests that depressive symptoms and perceived control play an important role in the recovery among post-CABG patients. Application of policies to assess depressive symptoms and improve perceived control prior to CABG by health care providers might decrease morbidity and mortality.

Relationship between anxiety, post-traumatic stress, insomnia and fibromyalgia among female refugees in jordan: A cross-sectional study.

WHAT IS KNOWN ON THE SUBJECT?: Fibromyalgia (FM) is a syndrome of chronic widespread pain, typically associated with fatigue, sleep, cognitive dysfunction and disordered mood. FM may limit an individual's ability to participate in everyday work and social activities, thereby making it difficult to maintain normal relationships with other individuals. While it has been studied in different populations and settings, the impact of FM and associated psychological factors has not been previously studied among female war refugees. WHAT DOES THE PAPER ADD TO EXISTING KNOWLEDGE?: The study showed the high impact of FM on female refugees in Jordan; approximately three quarters of the participants had a moderate to severe FM impact. Refugees settled in Irbid city, Iraq, showed increased age, anxiety and post-traumatic stress disorder correlated with a higher FM impact. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The study recommends evaluation of the impact of FM among all female refugees living in Jordan, along with its neighbouring countries hosting refugees. Healthcare providers, including mental health nurses, should be aware of the role of PTSD and anxiety on the impact of FM. Accordingly, healthcare workers should design appropriate mental health treatment plans to help to decrease the impact of FM. Mental health nurses should evaluate FM impact among all refugees worldwide. Nurses in Jordan are recommended to share their experience with nurses outside of Jordan as this may help with funds being obtained and the implementation of advanced psychological interventions. ABSTRACT: INTRODUCTION: Fibromyalgia (FM) is a syndrome of chronic widespread pain. While it has been studied in different populations and settings, the impact of FM and its associated psychological factors has not been previously studied among female war refugees. AIM: To assess the impact of FM and its associated factors in female refugees. METHODS: A cross-sectional study was conducted. The impact of FM, anxiety, post-traumatic stress (PTSD) and insomnia was investigated. RESULTS: 288 refugees previously diagnosed with FM were recruited. The results showed that 73.62% of the participants had a moderate to severe FM impact. Refugees settled in Irbid city were six times more likely to have a higher FM impact than refugees settled in Zarqa, and Iraqi refugees were more likely to have a higher impact than Syrian. Increased age, anxiety and PTSD were correlated with a greater impact. CONCLUSION: Mental health nursing services should be directed towards female refugees, particularly those with increased age, anxiety and PTSD. IMPLICATIONS FOR PRACTICE: Mental health nurses should evaluate the FM impact among all refugees worldwide. Furthermore, nurses in Jordan are recommended to share their experiences with nurses outside of Jordan, as this may help to raise funds and implement advanced psychological interventions.

Public knowledge, attitudes, and practice about COVID-19 pandemic.

COVID-19 is a newly discovered global pandemic that affected almost all countries, including Jordan. Knowledge, attitude and practices are fundamental to suppress the spread of the virus. This study aimed to examine knowledge, attitude and practices about COVID-19 in Jordan. A cross-sectional design was used to recruit a convenience sample of public from Jordan. An online instrument used to assess knowledge, attitude and practices about COVID-19, and was developed by the research team. The data were collected online through social media networks in Jordan. The data were collected during May 2020. 2470 participants participated and completed the study questionnaire. Results indicated good knowledge, practice, and attitude, about COVID-19 among the public in Jordan. Linear regression showed that female, aged 40 years or more, married, with Bachelor degree or higher, employed, and participants believe that Jordan will control COVID-19 had higher knowledge compared to their counterparts. Besides, linear regression showed that female, living in Amman city, with high knowledge about COVID-19, and believing that Jordan will control COVID-19 had higher practice compared to their counterparts. Knowledge, attitude and practices levels regarding COVID-19 among Jordanian population during the pandemic were high. However, health authorities and government have to implement and maintain educational programs to enhance the Jordanian population's awareness regarding COVID-19 and to prevent its spread specially among male, aged less than 40 years, unmarried, with less than Bachelor degree, unemployed, and for participants believe that Jordan will not control COVID-19.

The impact of preoperative pain-related psychological factors on pain intensity post-surgery in Jordan.

This study aimed to investigate the impact of preoperative psychological factors on postoperative pain. We included 300 postoperative patients who underwent open reduction and internal fixation surgery. Pain Scale, Pain Catastrophizing Scale, and Depression, Anxiety, and Stress Scale were completed by patients preoperatively and at 24 hours after surgery. Clinical characteristics were obtained from medical records. Data were analyzed using multiple linear regression. Postoperative pain was predicted by pain catastrophizing and anxiety symptoms. High preoperative catastrophizing and anxiety levels were associated with increased pain postoperatively. However, the relationships between preoperative depressive and stress symptoms and postoperative pain were not significant.

Physical Activity and Cardiac Self-Efficacy Levels During Early Recovery After Acute Myocardial Infarction: A Jordanian Study.

BACKGROUND: Regular physical activity is important for patients with established coronary heart disease as it favorably influences their coronary risk profile. General self-efficacy is a powerful predictor of health behavior change that involves increases in physical activity levels. Few studies have simultaneously measured physical activity and self-efficacy during early recovery after a first acute myocardial infarction (AMI). PURPOSE: The aims of this study were to assess changes in objectively measured physical activity levels at 2 weeks (T2) and 6 weeks (T3) and self-reported cardiac self-efficacy at hospital discharge (T1) and at T2 and T3 in patients recovering from AMI. METHODS: A repeated-measures design was used to recruit a purposive sample of patients from a single center in Jordan who were diagnosed with first AMI and who did not have access to cardiac rehabilitation. A body-worn activity monitor (activPAL) was used to objectively measure free-living physical activity levels for 7 consecutive days at two time points (T2 and T3). An Arabic version of the cardiac self-efficacy scale was administered at T1, T2, and T3. Paired t tests and analysis of variance were used to examine differences in physical activity levels and cardiac self-efficacy scores, respectively. RESULTS: A sample of 100 participants was recruited, of which 62% were male. The mean age of the sample was 54.5 ± 9.9 years. No statistically significant difference in physical activity levels was measured at 2 weeks (T2) and 6 weeks (T3). Cardiac self-efficacy scores improved significantly between T1, T2, and T3 across subscales and global cardiac self-efficacy. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: Participants recovering from AMI in Jordan did not increase their physical activity levels during the early recovery phase, although cardiac self-efficacy scores improved. This may be because the increase in cardiac self-efficacy was not matched by the practical skills and knowledge required to translate this positive psychological construct into behavioral change. This study provides a first step toward understanding the complex relationship between cardiac self-efficacy and physical activity in this population. The authors hope that these findings support the design of culturally appropriate interventions to increase physical activity levels in this population.

Changes in illness perception among patients' undergoing percutaneous coronary intervention.

BACKGROUND: Little is known about changes in illness perception (IP) among patients treated with percutaneous coronary intervention (PCI). OBJECTIVES: To examine changes in IP among patients undergoing PCI and examine the effects of demographics and clinical details on IP. METHODS: A descriptive repeated measures design was used. IP was evaluated at pre discharge time and six months' later. RESULTS: Six months' post PCI, patients perceived their illness as chronic, had more control over their condition, and better understanding of it. They experienced less symptoms, lower perceptions of consequences on their life and less emotional representation indicating positive changes. Receiving health education at follow-up time had a significant interaction effects on increased personal and treatment control. Having a family history of coronary heart disease associated with better understanding of illness. CONCLUSION: Assessing patient' IP and providing health education at follow-up time should be incorporated in optimizing the care of PCI patients.

A cross-cultural translation and adaptation of the Arabic Cardiac Self-Efficacy Questionnaire for patients with coronary heart disease.

AIM: The aim of this study is to cross-culturally translate and adapt the Cardiac Self-Efficacy Questionnaire into Arabic and subsequently evaluate the psychometric properties of that translation in a population of Arabic patients. METHOD: The original English version of the Cardiac Self-Efficacy Questionnaire was translated into Arabic following a process recommended by the World Health Organization. A convenience sample consisting of 268 Jordanian patients with coronary heart disease was recruited from a university-affiliated hospital in Amman, Jordan. Data were collected from October 2018 to March 2019. The factor structure, face and content validities, and internal consistency of the Arabic Cardiac Self-Efficacy Questionnaire (A-CSEQ) were evaluated. RESULTS: The factor structure analysis supported a three-factor high-order structure of the A-CSEQ. Face validity showed that the language used, style, and format were clear. The content validity demonstrated a very good content validity index. The reliability was good with ranging from 0.89 to 0.93 for all questionnaire subscales. CONCLUSION: The A-CSEQ is a valid and reliable instrument to assess the cardiac self-efficacy of Arabic patients diagnosed with coronary heart disease. Further assessment of the psychometric properties of the A-CSEQ with different cardiac problems is now recommended.

Impacts of Treatment Modalities on Physical Activity After First Acute Myocardial Infarction in Jordan.

BACKGROUND: Promoting physical activity is a priority after coronary revascularisation for effective long-term cardiovascular care and to avoid further disease progression and complications. But little is known about the effect of different types of acute myocardial infarction (AMI) treatment modalities in changes in physical activity level post-AMI. OBJECTIVE: This study aimed to examine changes in physical activity among patients treated with different treatment modalities post-first AMI during early recovery phase at week 2 (time 1) and week 6 (Time 2) after hospitalization. METHODS: A descriptive study was done using a repeated-measures design. Physical activity was measured by a body-worn activity monitor (activPAL3 monitor) for 24 hours a day for full 7 consecutive days at time 1 and time 2 after hospitalization. Demographic and clinical data were collected from patients' records. The study was conducted in 1 setting in Jordan. Participants were met at time 1 and time 2. The study recruited a convenience sample of 94 patients with AMI. Participants did not have access to cardiac rehabilitation. The participants were categorized according to type of AMI treatment modalities into 3 groups: ST-elevation myocardial infarction treated by primary percutaneous coronary intervention, ST-elevation myocardial infarction treated by thrombolytic therapy, and non-ST-elevation myocardial infarction treated by medication. RESULTS: Patients treated by primary percutaneous coronary intervention had a statistically significant effect on changes in mean steps count and mean stepping time per day better than patients treated by other treatment modalities between weeks 2 and 6 after hospitalization. CONCLUSION: The study showed that patients treated with primary percutaneous coronary intervention had better mean steps count and mean stepping time per day between weeks 2 and 6 after hospitalization in comparison with other treatment modalities. These findings could be used for development of effective intervention in the future. Further research using different research methods such as longitudinal studies among different cultures to confirm the finding of this study is recommended.