College of Nursing, University of Nebraska Medical Center, Lincoln, Nebraska 68588-0220, USA.
Heart Lung. 2011 Sep-Oct;40(5):429-39. doi: 10.1016/j.hrtlng.2010.07.018. Epub 2011 Apr 17.
Despite known gender differences in recovery, few studies have examined symptom management (SM) interventions or responses by gender after coronary artery bypass surgery (CABS).
The purpose of this subanalysis was to describe and evaluate differences in response by gender to an SM intervention on the presence and burden of symptoms, physical activity, and physical functioning in elderly CABS patients during the early discharge period (3 and 6 weeks after CABS, and 3 and 6 months after CABS).
The parent study whose data were analyzed to examine gender differences involved a two-group, randomized clinical trial design. The 6-week early recovery SM telehealth intervention was delivered by the Health Buddy. Measures included the Cardiac Symptom Survey, a Modified 7-Day Activity Interview, an RT3 accelerometer, an Activity Diary, and the Medical Outcomes Study Short Form 36. This study was not powered for a gender × group analysis, and we used descriptive statistics, χ(2) tests, t tests, and analysis of variance for statistical analyses.
Subjects (n = 232) included 192 men and 40 women, with a mean age of 71.2 SD, 7 years. The intervention group consisted of 86 men and 23 women, and the usual care (UC) group consisted of 106 men and 17 women. Data trends suggest that the SM intervention exerted greater impact on women than on men for symptoms such as fatigue, depression, sleep problems, and pain. Again, men exhibited higher levels of physical activity than did women. However, women in the SM group generally had higher scores than did women in the UC group.
Although the parent study found no effect of an early recovery SM intervention, this exploratory secondary analysis indicated that women in the intervention group demonstrated more improvement in measures of physical activity than did those in the UC group. Further study, using a larger sample, is necessary to test these preliminary results.
尽管已知性别在康复方面存在差异,但很少有研究检查过性别对冠状动脉旁路手术后(CABS)的症状管理(SM)干预或反应。
本亚分析的目的是描述和评估性别对 SM 干预的反应差异,以了解在 CABS 后早期出院期间(CABS 后 3 周和 6 周,以及 CABS 后 3 个月和 6 个月)老年 CABS 患者的症状存在和负担、体力活动和身体功能的影响。
分析数据以检查性别差异的母研究采用了两组随机临床试验设计。为期 6 周的早期康复 SM 远程医疗干预由 Health Buddy 提供。测量包括心脏症状调查、改良 7 天活动访谈、RT3 加速度计、活动日记和医疗结局研究简明健康调查问卷 36 项。这项研究没有针对性别×组分析的能力,我们使用描述性统计、χ(2)检验、t 检验和方差分析进行统计分析。
受试者(n=232)包括 192 名男性和 40 名女性,平均年龄为 71.2±7 岁。干预组包括 86 名男性和 23 名女性,常规护理(UC)组包括 106 名男性和 17 名女性。数据趋势表明,SM 干预对女性的疲劳、抑郁、睡眠问题和疼痛等症状的影响大于男性。同样,男性的体力活动水平高于女性。然而,SM 组的女性通常比 UC 组的女性得分更高。
尽管母研究未发现早期康复 SM 干预的效果,但这项探索性二次分析表明,干预组的女性在体力活动测量方面的改善程度高于 UC 组。需要使用更大的样本量进一步研究,以检验这些初步结果。