Scotto Carrie J, Waechter Donna J, Rosneck James
The University of Akron, College of Nursing, Ohio, USA.
Can J Cardiovasc Nurs. 2011;21(4):11-7.
Adherence to diet and exercise regimens significantly limits morbidity and mortality for cardiac patients. Research at six and 12 months post CR program indicates that healthy behaviours learned in CR are not sustained. However, little is known about the extent of adherence in the immediate program completion period.
To determine CR participants' knowledge of their diet and exercise prescription and the degree of adherence two months after completing CR, and to examine demographic and clinical variables to identify relationships to adherence behaviours.
Participants (n = 174) were recruited from Phase II CR over a one-year period. The Diet Habit Survey (DHS) and Duke Activity Status Index (DASI) scores were administered at admission, discharge, and two months post discharge. Structured telephone interviews were conducted to evaluate adherence behaviours. Spearman correlation was used to determine relationships between demographic and clinical variables and adherence behaviours.
Repeated measures ANOVA showed DHS and DASI scores were significantly higher at discharge (p < 0.001) without significant drift at two months post program (p < 0.09). These scores were in contrast with low self-report of knowledge of dietary and exercise recommendations and adherence to dietary and exercise instructions. Lower knowledge about diet and exercise were correlated with employment (diet, p < 0.001; exercise, p < 0.025). Decreased dietary adherence was correlated with BMI (p < 0.005). Exercise adherence was correlated with gender (p < 0.021) and marital status (p < 0.042).
Although CR participants gain and retain knowledge about necessary dietary changes and improve their exercise activity tolerance during CR, most fail to translate the information into health promoting behaviour changes beginning in the immediate discharge period. Research to identify methods that transform knowledge into lasting behaviour change post CR is needed.
坚持饮食和运动方案可显著降低心脏病患者的发病率和死亡率。心脏康复（CR）项目结束后6个月和12个月的研究表明，在CR中学到的健康行为无法持续。然而，对于项目刚结束时的坚持程度知之甚少。
确定CR参与者在完成CR两个月后对其饮食和运动处方的了解程度以及坚持程度，并检查人口统计学和临床变量，以确定与坚持行为的关系。
在一年时间内从II期CR中招募参与者（n = 174）。在入院、出院时以及出院后两个月进行饮食习惯调查（DHS）和杜克活动状态指数（DASI）评分。通过结构化电话访谈评估坚持行为。采用Spearman相关性分析来确定人口统计学和临床变量与坚持行为之间的关系。
重复测量方差分析显示，出院时DHS和DASI评分显著更高（p < 0.001），项目结束后两个月无显著变化（p < 0.09）。这些评分与对饮食和运动建议的了解以及对饮食和运动指导的坚持程度的低自我报告形成对比。对饮食和运动的了解较少与就业情况相关（饮食，p < 0.001；运动，p < 0.025）。饮食坚持程度降低与体重指数相关（p < 0.005）。运动坚持程度与性别（p < 0.021）和婚姻状况（p < 0.042）相关。
尽管CR参与者在CR期间获得并保留了有关必要饮食变化的知识，并提高了运动活动耐量，但大多数人在出院后立即未能将这些信息转化为促进健康的行为改变。需要开展研究以确定将知识转化为CR后持久行为改变的方法。
