Fernandez Ritin S, Davidson Patricia, Griffiths Rhonda, Juergens Craig, Stafford Bruce, Salamonson Yenna
South Western Sydney, Centre for Applied Nursing Research, NSW, Australia.
Aust Crit Care. 2009 Feb;22(1):17-27. doi: 10.1016/j.aucc.2008.10.003. Epub 2008 Dec 9.
This pilot study was to assess the feasibility of the health-related lifestyle self-management (HeLM) intervention as a strategy to decrease cardiovascular risk following acute coronary syndrome.
Participants in this randomised controlled trial were recruited from a tertiary teaching hospital in metropolitan Sydney Australia. The multifaceted HeLM intervention, using the principles of the transtheoretical model, involved the use of bibliotherapy, a structured evidence-based approach to cardiovascular risk reduction, a communication strategy with general practitioners, three supportive telephone calls to participants and provision of behavioural prompts and a health record diary. Differences in behavioural and clinical outcomes between the HeLM intervention group (n=29) and the standard cardiac rehabilitation group (n=22) were assessed.
A total of 125 participants screened were eligible for participation in the study. Fifty-one participants, mean age 57 years (+/-8.78) were randomised. At the 8-week follow-up, participants in the HeLM intervention group had a reduced systolic blood pressure compared to the standard care group (120.3 S.D.: 16.3 vs. 126.4 S.D.: 14.6). There were no significant differences in diastolic blood pressure and cholesterol levels between the two groups. Participants in both the intervention and control group had a reduction in waist circumference although when compared to baseline values, women in the HeLM intervention group had a greater reduction compared to those receiving standard care. Patients reported high levels of satisfaction with this intervention.
Findings support the feasibility of implementing the health-related lifestyle self-management intervention for risk factor modification in patients with acute coronary syndrome. An adequately powered randomised controlled trial is required to test the impact of the intervention on cardiovascular risk reduction.
本试点研究旨在评估健康相关生活方式自我管理（HeLM）干预作为降低急性冠状动脉综合征后心血管风险策略的可行性。
本随机对照试验的参与者从澳大利亚悉尼大都市的一家三级教学医院招募。多方面的HeLM干预采用了跨理论模型的原则，包括使用书籍疗法、一种基于证据的结构化心血管风险降低方法、与全科医生的沟通策略、给参与者的三次支持性电话以及提供行为提示和健康记录日记。评估了HeLM干预组（n = 29）和标准心脏康复组（n = 22）在行为和临床结果上的差异。
总共筛选出125名符合参与研究条件的参与者。51名参与者（平均年龄57岁，±8.78）被随机分组。在8周的随访中，与标准护理组相比，HeLM干预组的参与者收缩压有所降低（120.3标准差：16.3 vs. 126.4标准差：14.6）。两组之间舒张压和胆固醇水平无显著差异。干预组和对照组的参与者腰围均有所减少，尽管与基线值相比，HeLM干预组的女性腰围减少幅度大于接受标准护理的女性。患者对该干预措施的满意度较高。
研究结果支持对急性冠状动脉综合征患者实施健康相关生活方式自我管理干预以改变危险因素的可行性。需要进行一项有足够样本量的随机对照试验来测试该干预对降低心血管风险的影响。
