dissertationThis investigation sought to determine if a nursing intervention with first degree relatives (children, siblings, parents, and spouses) of victims of sudden cardiac death would promote change in high risk behaviors for coronary heart disease. The Nursing; intervention strategy was designed to assess, inform/educate and provide emotional support regarding familial/genetic risk factors, cardiovascular behavioral risk factors, and health beliefs. The study design was a two group experimental design using repeated measures of health beliefs and health behaviors with random assignment of subjects into groups. The sample consisted of 58 first degree relatives of sudden death victims referred for autopsy by the County Coroner. The outcome measures included changes in health beliefs, health behaviors and whether or not subjects elected screening for blood pressure and serum cholesterol. Approximately 65%, or 12 of 16 families demonstrated familial aggregation of cardiac diseases. Analysis of covariance was used to determine health behavior, health beliefs, and knowledge differences between groups on health beliefs. There were significant differences between sibling groups on how susceptible they reported their children to be to cardiac disease and how serious they perceived cardiac disease to be. Health habit differences included significant reductions in the experimental group on alcohol and meat consumption. There were no statistically significant group differences on knowledge, although the experimental group increased in knowledge while the control remained the same. Seventy-six percent of the experimental group did have blood pressure screening compared to 57% in the control. In the experimental group, 27% had serum cholesterol screening compared to 14% of the control group. Qualitative data were collected on the events leading to death for the sudden death victim, risk factors associated with sudden death, and the family member's perceptions of sudden cardiac death. Nursing intervention made a difference for experimental siblings (the highest risk group) on health beliefs (increased perceived susceptibility and severity) health behaviors (alcohol and meat consumption) and screening for blood pressure and serum cholesterol. Primary preventive intervention holds promise for reduction of cardiovascular mortality
