Johnson Natalie A, Inder Kerry J, Ewald Ben D, James Erica L, Bowe Steven J
School of Medicine and Public Health, Faculty of Health, The University of Newcastle, Callaghan, Newcastle, NSW 2308, Australia.
Rehabil Res Pract. 2010;2010:541741. doi: 10.1155/2010/541741. Epub 2010 Dec 16.
We test the hypothesis that the odds of self-reported receipt of lifestyle advice from a health care provider will be lower among outpatient cardiac rehabilitation (OCR) nonattendees and nonreferred patients compared to OCR attendees. Logistic regression was used to analyse cross-sectional data provided by 65% (4971/7678) of patients aged 20 to 84 years discharged from public hospitals with a diagnosis indicating eligibility for OCR between 2002 and 2007. Among respondents, 71% (3518) and 55% (2724) recalled advice regarding physical activity and diet, respectively, while 88% (592/674) of smokers recalled quit advice. OCR attendance was low: 36% (1764) of respondents reported attending OCR, 11% (552) did not attend following referral, and 45% (2217) did not recall being invited. The odds of recalling advice regarding physical activity and diet were significantly lower among OCR nonattendees compared to attendees (OR 0.34, 95% CI 0.21, 0.56 and OR 0.33, 95% CI 0.25, 0.44, resp.) and among nonreferred respondents compared to OCR attendees (OR 0.10, 95% CI 0.07, 0.15 and OR 0.17, 95% CI 0.14, 0.22, resp.). Patients hospitalised for coronary heart disease should be referred to OCR or a suitable alternative to improve recall of lifestyle advice that will reduce the risk of further coronary events.
与门诊心脏康复(OCR)参与者相比,未参加OCR的患者以及未被转诊的患者从医疗保健提供者那里获得自我报告的生活方式建议的几率会更低。采用逻辑回归分析2002年至2007年间从公立医院出院、诊断表明符合OCR条件的65%(4971/7678)年龄在20至84岁的患者提供的横断面数据。在受访者中,分别有71%(3518)和55%(2724)回忆起了关于体育活动和饮食的建议,而88%(592/674)的吸烟者回忆起了戒烟建议。OCR的参与率较低:36%(1764)的受访者报告参加了OCR,11%(552)在被转诊后未参加,45%(2217)不记得被邀请过。与参与者相比,未参加OCR的患者回忆起体育活动和饮食建议的几率显著更低(分别为OR 0.34,95%CI 0.21,0.56和OR 0.33,95%CI 0.25,0.44),与OCR参与者相比,未被转诊的受访者回忆起相关建议的几率也显著更低(分别为OR 0.10,95%CI 0.07,0.15和OR 0.17,95%CI 0.14,0.22)。因冠心病住院的患者应被转诊至OCR或合适的替代方案,以提高对生活方式建议的回忆,从而降低进一步发生冠心病事件的风险。