Sher T G, Bellg A J, Braun L, Domas A, Rosenson R, Canar W J
Illinois Institute of Technology, Institute of Psychology, Chicago 60616, USA.
Health Educ Res. 2002 Oct;17(5):597-605. doi: 10.1093/her/17.5.597.
Long-term maintenance of behavioral change to reduce health risk factors is essential to producing a positive effect on medical outcomes. This study examines whether an ongoing, long-term relationship can be used to help patients diagnosed with coronary artery disease adhere to a risk-reducing behavioral intervention and maintain healthy behavioral changes. One hundred and sixty patients with diagnosed coronary artery disease will be randomized to a standard behavioral treatment group or to a standard behavioral treatment group including a couples intervention and followed for 18 months. The treatment in both groups follows tenets of cognitive behavioral and Self-Determination Theories as well as the Transtheoretical Model of Behavior Change. In addition, the couples intervention is designed to (1) change the patient's environment to facilitate cardiac risk-reducing behavioral changes, (2) optimize social reinforcement and motivation for behavior change, and (3) decrease relationship stress. Behavioral outcomes assessed include adherence to an exercise regimen, adherence to dietary recommendations and adherence to lipid-lowering medication. Lipid values, psychological variables and relationship variables are assessed throughout the study and at follow-up. While we expect both groups of cardiac patients to successfully adapt new health behaviors, we expect the couples intervention to be superior in helping maintain long-term health behaviors.
长期维持行为改变以降低健康风险因素对于对医疗结果产生积极影响至关重要。本研究探讨了一种持续的长期关系是否可用于帮助被诊断患有冠状动脉疾病的患者坚持降低风险的行为干预并维持健康的行为改变。160名被诊断患有冠状动脉疾病的患者将被随机分为标准行为治疗组或包括夫妻干预的标准行为治疗组，并随访18个月。两组的治疗均遵循认知行为理论、自我决定理论以及行为改变的跨理论模型的原则。此外，夫妻干预旨在：（1）改变患者的环境以促进降低心脏风险的行为改变；（2）优化社会强化和行为改变的动机；（3）减轻关系压力。评估的行为结果包括坚持运动方案、坚持饮食建议以及坚持服用降脂药物。在整个研究过程中和随访时评估血脂值、心理变量和关系变量。虽然我们预计两组心脏病患者都能成功适应新的健康行为，但我们预计夫妻干预在帮助维持长期健康行为方面更具优势。
