Gilbertson Sandra L, Graves Barbara Ann
Sandra L. Gilbertson, DNP Pediatric Nurse Practitioner, Heartland Pediatric and Adult Care, Heartland Regional Medical Center, St Joseph, Missouri. Barbara Ann Graves, PhD Associate Professor, Faculty Advisor, Capstone College of Nursing, The University of Alabama, Tuscaloosa.
J Cardiovasc Nurs. 2015 Jan-Feb;30(1):E8-18. doi: 10.1097/JCN.0000000000000126.
Identifying risk factors for cardiovascular disease (CVD) early in life gives advanced practice nurses an opportunity to educate parents about choices that promote long-term heart health. The addition of universal lipid screening to 9- to 11-year-old well-child examinations opens a time interval that is adequate for conversations related to cardiovascular health.
The objective of this study was to determine if the use of a 10-minute health promotion plan that includes identification of child modifiable CVD risk factors would have an effect on parental intent to engage in lifestyle changes that promote heart health in 9- to 11-year-old children.
The quasi-experimental pilot study involved 26 English-speaking parents of 9- to 11-year-old children during routine well-child examinations. Participants completed questionnaires before and after receiving a health promotion plan and the child's modifiable CVD risk screening results. The advanced practice nurse-researcher analyzed the questionnaires to evaluate parental intent to promote lifestyle changes.
Increases were seen in concern for the child's future heart health and in awareness of diet and exercise recommendations. Participants were likely to encourage more fruits and vegetables (100%), limit "screen time" (96%), encourage physical activity (92%), and limit sugar-sweetened beverage intake (96%). Factors identified as most influential on participant decision to encourage change were the child's body mass index (38.46%), lipid screening results (23.08%), and "other"-tobacco smoke exposure (15.38%), which closely approximate national prevalence for each risk category.
The American Academy of Pediatrics recommends lipid screening once for all children between 9 and 11 years of age. In this study, outlining recommendations for good health and identifying modifiable CVD risk factors showed a positive effect on parental intent to encourage lifestyle changes. Further research is needed to advance the science of CVD prevention and risk reduction in children.
在儿童早期识别心血管疾病(CVD)的风险因素,为高级执业护士提供了一个机会,可借此教育家长做出有助于长期心脏健康的选择。在9至11岁儿童的健康检查中增加通用血脂筛查,开启了一段足够的时间间隔,便于进行与心血管健康相关的对话。
本研究的目的是确定使用一份10分钟的健康促进计划(包括识别儿童可改变的CVD风险因素)是否会对家长鼓励9至11岁儿童做出促进心脏健康的生活方式改变的意愿产生影响。
这项准实验性试点研究纳入了26名9至11岁儿童的讲英语的家长,在其进行常规健康检查期间参与研究。参与者在收到健康促进计划和儿童可改变的CVD风险筛查结果之前和之后完成问卷。高级执业护士研究人员分析问卷,以评估家长促进生活方式改变的意愿。
家长对孩子未来心脏健康的关注度以及对饮食和运动建议的知晓度有所提高。参与者很可能会鼓励孩子多吃水果和蔬菜(100%)、限制“屏幕时间”(96%)、鼓励体育活动(92%)以及限制含糖饮料摄入量(96%)。被确定为对参与者鼓励改变的决定影响最大的因素是孩子的体重指数(38.46%)、血脂筛查结果(23.08%)以及“其他”——接触烟草烟雾(15.38%),这些与每个风险类别的全国患病率相近。
美国儿科学会建议对所有9至11岁的儿童进行一次血脂筛查。在本研究中,概述健康建议并识别可改变的CVD风险因素对家长鼓励生活方式改变的意愿产生了积极影响。需要进一步研究以推动儿童CVD预防和风险降低科学的发展。