Meng Karin, Seekatz Bettina, Haug Günter, Mosler Gabriele, Schwaab Bernhard, Worringen Ulrike, Faller Hermann
Department of Medical Psychology, Medical Sociology, and Rehabilitation Sciences, University of Würzburg, D-97070 Würzburg, Germany, Rehabilitation Center Bayerisch Gmain, D-83457 Bayerisch Gmain, Germany, Rehabilitation Hospital Höhenried, D-82347 Bernried, Germany, Curschmann Klinik, Rehabilitation Hospital, D-23669 Timmendorfer Strand, Germany and Department Rehabilitation, German Statutory Pension Insurance Scheme, D-10709 Berlin, Germany.
Health Educ Res. 2014 Apr;29(2):235-46. doi: 10.1093/her/cyt107. Epub 2014 Jan 7.
Patient education is an essential part of the treatment of coronary heart disease in cardiac rehabilitation. In Germany, no standardized and evaluated patient education programs for coronary heart disease have been available so far. In this article, we report the evaluation of a patient-oriented program. A multicenter quasi-experimental, sequential cohort design study of patients with coronary heart disease (n = 434) in inpatient cardiac rehabilitation was conducted. Intervention patients received the new patient-oriented program, control patients a traditional lecture-based program (usual care). Primary outcome illness knowledge and secondary behavioral and health outcomes were assessed at admission, discharge and 6- and 12-months follow-up. We found a significant, small between-group intervention effect in both patients' medical illness and treatment knowledge and behavior change knowledge at discharge (medical: η(2) = 0.013; behavior change: η(2) = 0.011) and after 12 months (medical: η(2) = 0.015). Furthermore, a significant, small effect was observed for physical activity after 12 months (η(2) = 0.011), but no effects on healthy diet and medication adherence emerged. Superiority of the patient-oriented educational program for patients with coronary heart disease was partially confirmed. The program produced improved illness knowledge and physical activity compared with usual care after 1 year.
患者教育是心脏康复中冠心病治疗的重要组成部分。在德国,目前尚无针对冠心病的标准化且经过评估的患者教育项目。在本文中,我们报告了一项以患者为导向的项目的评估情况。对住院心脏康复的冠心病患者(n = 434)进行了一项多中心准实验性序贯队列设计研究。干预组患者接受新的以患者为导向的项目,对照组患者接受传统的基于讲座的项目(常规护理)。在入院、出院以及6个月和12个月随访时评估主要结局疾病知识以及次要行为和健康结局。我们发现,在出院时(医学知识:η(2) = 0.013;行为改变知识:η(2) = 0.011)以及12个月后(医学知识:η(2) = 0.015),两组在患者的医学疾病和治疗知识以及行为改变知识方面均存在显著的小的组间干预效应。此外,12个月后在身体活动方面观察到显著的小的效应(η(2) = 0.011),但在健康饮食和药物依从性方面未出现效应。以患者为导向的冠心病教育项目的优越性得到了部分证实。与常规护理相比,该项目在1年后使疾病知识和身体活动得到了改善。