Cobb Stephanie L, Brown Debra J, Davis Leslie L
Healthlink, University of North Carolina Healthcare, Chapel Hill, NC, USA.
J Am Acad Nurse Pract. 2006 Jan;18(1):31-9. doi: 10.1111/j.1745-7599.2006.00096.x.
This science clinical paper reviews medical literature and examines interventions that are currently used to assist patients in achieving lifestyle change after myocardial infarction or coronary artery revascularization. Interventions that focused on both provider- and patient-implemented strategies were included. The effectiveness of these interventions to significantly reduce coronary heart disease risk factors was explored.
Original longitudinal research studies or reviews indexed in PubMed between 1999 and 2004 were included. Eight studies were identified that met the inclusion criteria and presented successful interventions to increase participants' adherence to recommended lifestyle changes.
Current strategies for achieving recommended risk factor reductions include frequent follow-up, intensive diet changes, individualized and group exercise, coaching, group meetings, education on lifestyle modification and behavior change, and formal cardiac rehabilitation programs.
Nurse Practitioners can help close the gap between evidence-based recommendations and clinical practice by implementing education programs in their practices and in the community. Recommendations include frequent follow-up visits, negotiating personalized treatment plans, and a general emphasis on therapeutic lifestyle change as an essential component of the treatment plan.
本科学临床论文回顾医学文献,并研究目前用于帮助心肌梗死或冠状动脉血运重建术后患者实现生活方式改变的干预措施。纳入了侧重于医生和患者实施策略的干预措施。探讨了这些干预措施显著降低冠心病危险因素的有效性。
纳入1999年至2004年间在PubMed上索引的原始纵向研究或综述。确定了八项符合纳入标准并提出成功干预措施以提高参与者对推荐生活方式改变的依从性的研究。
目前实现推荐的危险因素降低的策略包括频繁随访、强化饮食改变、个体化和团体运动、指导、团体会议、生活方式改变和行为改变教育以及正式的心脏康复计划。
执业护士可以通过在其实践和社区中实施教育计划来帮助缩小循证推荐与临床实践之间的差距。建议包括频繁的随访就诊、协商个性化治疗计划以及普遍强调治疗性生活方式改变作为治疗计划的重要组成部分。