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有效应对心力衰竭(COPE-HF):基于电话的应对技能干预的设计和原理。

Coping effectively with heart failure (COPE-HF): design and rationale of a telephone-based coping skills intervention.

机构信息

Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27710, USA.

出版信息

J Card Fail. 2011 Mar;17(3):201-7. doi: 10.1016/j.cardfail.2010.11.001. Epub 2011 Jan 21.

Abstract

BACKGROUND

Coping Effectively with Heart Failure (COPE-HF) is an ongoing randomized clinical trial funded by the National Institutes of Health to evaluate if a coping skills training (CST) intervention will result in improved health status and quality of life as well as reduced mortality and hospitalizations compared with a heart failure education (HFE) intervention.

METHODS AND RESULTS

Two hundred heart failure (HF) patients recruited from the Duke University Medical Center and the University of North Carolina Hospital system will be randomized to a CST intervention (16 weekly 30-minute telephone counseling sessions including motivational interviewing and individually tailored cognitive behavioral therapy) or to an HFE intervention (16 weekly 30-minute telephone sessions including education and symptom monitoring). Primary outcomes will include postintervention effects on HF biomarkers (B-type natriuretic peptide, ejection fraction) and quality of life, as well as long-term clinical outcomes (hospitalizations and death). Secondary analyses will include an evaluation of treatment effects across subpopulations, and potential mechanisms by which CST may improve clinical outcomes.

CONCLUSIONS

COPE-HF is a proof-of-concept study that should provide important insights into the health benefits of a CST intervention designed to enhance HF self-management, improve health behaviors, and reduce psychologic distress.

摘要

背景

《有效应对心力衰竭(COPE-HF)》是一项正在进行的由美国国立卫生研究院资助的随机临床试验,旨在评估应对技能培训(CST)干预是否会导致健康状况和生活质量的改善,以及与心力衰竭教育(HFE)干预相比,死亡率和住院率的降低。

方法和结果

从杜克大学医学中心和北卡罗来纳大学医院系统招募的 200 名心力衰竭(HF)患者将被随机分配到 CST 干预组(16 周每周 30 分钟的电话咨询,包括动机访谈和个性化的认知行为疗法)或 HFE 干预组(16 周每周 30 分钟的电话会议,包括教育和症状监测)。主要结局将包括干预后 HF 生物标志物(B 型利钠肽、射血分数)和生活质量的变化,以及长期临床结局(住院和死亡)。次要分析将包括评估 CST 在亚人群中的治疗效果,以及 CST 改善临床结局的潜在机制。

结论

COPE-HF 是一项概念验证研究,应该为 CST 干预对增强 HF 自我管理、改善健康行为和减轻心理困扰的健康益处提供重要的见解。

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