Patricia Thomson, PhD, MPH, MA Lecturer, School of Nursing, Midwifery, and Health, University of Stirling, Scotland. Catherine A. Niven, PhD Emeritus Professor of Nursing and Midwifery, School of Nursing, Midwifery, and Health, University of Stirling, Scotland. David F. Peck, PhD Visiting Professor of Health Research, School of Nursing, Midwifery, and Health, University of Stirling, Scotland. Kate Howie, BSc(Hons) Teaching Fellow/Statistical Consultant, Institute of Computing Science and Mathematics, School of Natural Sciences, University of Stirling, Scotland.
J Cardiovasc Nurs. 2013 Nov-Dec;28(6):550-62. doi: 10.1097/JCN.0b013e31826341ae.
Coronary heart disease (CHD) risk factor reduction is required to maximize the benefits to be gained from coronary artery bypass grafting. Risk factor reduction after surgery, however, is often incomplete and adherence rates are poor. The health behaviors of the cardiac partner can be supportive or can act to undermine the patient's motivation for change in risk factors. Concordance in health behaviors in couples can make it more difficult for patients to engage in positive lifestyle changes.
The aims of this study were to increase understanding of the role of concordance in CHD risk factors and common medical conditions in patients and partners before and 4 months after bypass grafting and to examine changes in the pattern of concordance over time.
A prospective study of patients' and partners' CHD risk factors was conducted in the outpatient clinic before and at home 4 months after bypass grafting.
There was significant concordance for preoperative physical activity, body mass index, and diabetes mellitus, and postoperatively, there was significant concordance for smoking status, physical activity, body mass index, cholesterol, and diabetes mellitus. There were significant associations between patients' preoperative and postoperative physical activity and cholesterol and between the partners' preoperative and postoperative physical activity. There was a significant change in the pattern of concordance for physical activity from preoperation to postoperation, with more patients but not partners increasing their physical activity levels.
Results revealed significant concordance in CHD risk factors and common medical conditions in patients and partners before and 4 months after coronary artery bypass grafting. This indicates that the behaviors of some couples can make it more difficult for patients to change their lifestyle. The health professionals involved in educating patients before and after bypass grafting need to target the patient and partner as a couple to help achieve more successful risk factor reduction.
为了使冠状动脉旁路移植术的获益最大化，需要降低冠心病（CHD）的风险因素。然而，手术后的风险因素降低往往并不完全，且遵医率较差。心脏伴侣的健康行为可能具有支持作用，也可能破坏患者改变风险因素的动机。夫妻双方健康行为的一致性可能使患者更难进行积极的生活方式改变。
本研究旨在增加对患者和伴侣在冠状动脉旁路移植术前和术后 4 个月 CHD 风险因素和常见医学疾病一致性作用的理解，并检查一致性模式随时间的变化。
在冠状动脉旁路移植术前和术后 4 个月在门诊对患者和伴侣的 CHD 风险因素进行前瞻性研究。
术前体力活动、体重指数和糖尿病存在显著的一致性，术后吸烟状况、体力活动、体重指数、胆固醇和糖尿病也存在显著的一致性。患者术前和术后体力活动以及胆固醇之间存在显著相关性，伴侣术前和术后体力活动之间也存在显著相关性。从术前到术后，体力活动的一致性模式发生了显著变化，更多的患者而非伴侣增加了体力活动水平。
研究结果表明，患者和伴侣在冠状动脉旁路移植术前和术后 4 个月 CHD 风险因素和常见医学疾病存在显著的一致性。这表明一些夫妻的行为可能使患者更难改变其生活方式。在冠状动脉旁路移植术前和术后对患者进行教育的医疗保健专业人员需要将患者和伴侣作为一个整体作为目标，以帮助实现更成功的风险因素降低。
