Background: Cardiovascular diseases (CVDs) remain the leading cause of mortality worldwide, accounting for 32% of global deaths (World Health Organization [WHO], 2021). In Aotearoa New Zealand, ischaemic heart disease stands as the primary cause of death among various demographic groups, with 175,000 people living with heart disease (Heart Foundation, 2023a). Secondary prevention, specifically cardiac rehabilitation, has been proven to reduce mortality rates and further cardiac events. However, the effectiveness of such programmes relies on patients’ comprehension.

Aim: This research sought to investigate the current levels of understanding among individuals diagnosed with cardiovascular disease in Aotearoa New Zealand following their first engagement with acute cardiac hospital services. A tailored model for cardiac health education in acute care settings is proposed.

Method: Employing a fixed convergent mixed methods research design, by nationally administering a previously validated questionnaire, across five prominent cardiac centres throughout the country, while also conducting focus groups and individual interviews in Canterbury.

Results: The Aotearoa New Zealand knowledge scores obtained from the survey were parallel with international studies, indicating an overall ‘acceptable’ level of knowledge (63.04±13.38), with disparities associated with demographic characteristics such as prior educational levels, employment, smoking habits, age, and gender. Patients exhibited varying levels of knowledge across different aspects of cardiac health.

Qualitative findings revealed that patients perceived good knowledge of risk factors but struggled with medication instructions and exercise guidelines. Both patients and healthcare professionals highlighted a lack of formal assessment of understanding during the inpatient period and a need for standardised approaches. Information overload emerged as a potential barrier to knowledge retention. Moreover, the study highlighted the interplay between cardiovascular disease and mental health.

Mixed analysis revealed disparities and alignments between knowledge scores and acute cardiac patient and health care professionals’ insights, emphasising the impact of information overload on knowledge retention and the importance of mental health screening.

Conclusion: Despite progress in reducing CVD rates, there is a need for acute hospital cardiac rehabilitation, as it remains a crucial connection to specialised cardiac healthcare. The study recommends a future model of acute education practice, including rapid knowledge assessment and mental health screening. Addressing these aspects can improve patient outcomes and contribute to the ongoing efforts to combat cardiovascular diseases.