Table 1.

Contents of the interventions based on three constructs of the information-motivation-behavioral skills model

Constructs	Content presented during the study stages
	Educational motivational sessions	Telephone follow-ups
Informational intervention	• Pathophysiology of cardiovascular disease and its risk factors	• The informational content was reviewed during telephone sessions.
	• Surgical therapies	• The learned information were assessed.
	• Nutrition	• The benefits of applying home care advices were explained.
	• Exercise and activity
	• Smoking cessation	• Patients’ ambiguities about the disease and treatment measures were assessed and resolved.
	• Stress management
	• Medication consumption and importance of adherence to treatment and risks of non-adherence
Motivational intervention	• A two-hour motivational interview conducted in groups by a psychiatric nurse with MSc degree in order to enhance the patients’ motivation to change.	• During the follow ups, patients’ values and attitudes were sought.
	• The methods used for empowerment of motivation were applied in all training sessions included:	• Patients’ positive attitudes towards adherence to treatment were reinforced.
	o determining the patients’ motivations to change	• Benefits of adherence and costs of non-adherence were discussed.
	o encouraging the patient’s personal and social motivations to treatment adherence	• Patients’ confidence to treatment program and their readiness to change were explored.
	o encouraging patients’ self-reinforcement over time	• The change program was planned with the help of the patient.
	• The patients were guided through asking open questions, empathic listening, confirmation, and provision of feedback.	• The techniques such as asking open-ended questions and active listening were applied during follow ups to improve patients’ motivation to adherence.
Behavioral interventions	• Focused on the application of trainings in daily life	• During the follow-up period, the researcher assessed the patients’ execution of the intervention program and recorded the information in notebooks which its contents emphasized the patients’ performance as well as their progress in adherence to the guidelines and home care.
	• Specific techniques for integration of educational programs to daily activities were searched for each patient and emphasized	• Patients’ improvements were reinforced and if needed changes in activities was recommended during follow ups.
	• The patients’ adherence to the programs as well as their progress was explored	• The patients’ problems in implementing the intervention program at home were investigated.
	• Patients’ weak points were determined, and they were guided for better execution of the treatment program.	• Appropriate solutions to the patients’ problems with the help of patients themselves were sought.
		• The focus of the behavioral intervention was on the following areas:
		o examining how to apply the recommendations at home
		o how to control signs and symptoms (e.g. chest pain, dyspnea)
		o performing daily activities
		o the amount of exercise and activity and how to do it
		o assessing the process of quitting smoking
		o dietary management (asking the patient’s weekly diet)
		o stress management
		o patients’ using relaxation techniques
		o taking medications and how to control their side effects