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坚持心脏康复家庭项目护理模式:与成熟的传统现场监督项目的比较。

Adherence to a cardiac rehabilitation home program model of care: a comparison to a well-established traditional on-site supervised program.

机构信息

Department of Rehabilitation Science, University of Toronto, Toronto, ON M5T 1W5, Canada.

出版信息

Appl Physiol Nutr Metab. 2012 Apr;37(2):206-13. doi: 10.1139/h11-151. Epub 2012 Feb 23.

Abstract

Despite the proven benefits of cardiac rehabilitation (CR), adherence to programs remains suboptimal. To improve adherence, alternative models of care, such as using home programs (HP), have been recommended. Little information exists, however, about its effect on adherence in real-world settings. Therefore, this study's primary objective was to compare adherence of patients in an HP and traditional on-site program (TP) model of CR. The secondary objective was to compare their clinical and demographic profiles and changes in cardiovascular fitness. We implemented a retrospective review of 200 consecutively enrolled patients who chose either a TP or HP model. Profile data was collected at intake assessment. Adherence, defined as attendance to prescheduled contacts or on-site visits in each respective cohort, served as a primary outcome measure. Secondary outcomes included completion of program and cardiopulmonary fitness levels at 6 months. We found that the HP cohort had patients who were significantly younger, male (significantly moreso than female), were more geographically removed from the on-site centre, were employed, and (or) had greater cardiopulmonary fitness at initiation. Similar mean attendance (p = 0.21) and completion rates (p = 0.22) were seen between models. Both groups attained similar gains in cardiovascular fitness (p = 0.79). Analysis of adherence shows the HP to be a suitable option for patients who face barriers for TP-CR participation.

摘要

尽管心脏康复 (CR) 的益处已得到证实,但患者对其的依从性仍不理想。为了提高依从性,已经推荐了替代的护理模式,例如使用家庭方案 (HP)。然而,关于其在实际环境中对依从性的影响的信息很少。因此,本研究的主要目的是比较 HP 和传统现场方案 (TP) 模型的 CR 患者的依从性。次要目的是比较他们的临床和人口统计学特征以及心血管健康状况的变化。我们对 200 名连续入组的患者进行了回顾性研究,这些患者选择了 TP 或 HP 模式。在入组评估时收集了患者的个人资料。依从性被定义为在各自队列中按计划参加预约或现场访问的情况,作为主要的结果衡量标准。次要结果包括在 6 个月时完成方案和心肺健康水平。我们发现,HP 组的患者明显更年轻、男性(明显多于女性)、地理位置远离现场中心、有工作,并且(或)在开始时的心肺健康水平更高。两种模式的平均出勤率(p = 0.21)和完成率(p = 0.22)相似。两组患者的心血管健康状况都有类似的改善(p = 0.79)。对依从性的分析表明,HP 对于那些因参加 TP-CR 而面临障碍的患者是一个合适的选择。

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