Huang Yan-Jin, Parry Monica, Zeng Ying, Luo Yan, Yang Jing, He Guo-Ping
Department of Community Nursing, Xiangya Nursing School, Central South University, Changsha, PR China.
Department of Nurse Practitioner Field of Study, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada.
Asian Nurs Res (Korean Soc Nurs Sci). 2017 Sep;11(3):187-193. doi: 10.1016/j.anr.2017.07.004. Epub 2017 Aug 15.
Early detection and management of coronary heart disease (CHD) are embedded into many community health service and primary care practices in western countries. The Framingham CHD risk score has been used to predict CHD and mortality for nearly 20 years, and it has predicted CHD event risk accurately in multiethnic populations. The aim of this study was to access the effect of a 6-month community-based intervention on CHD risk in individuals at high risk.
A randomized controlled trial of individuals with a high 10-year CHD risk were recruited from two communities in China. Individuals in the intervention group (n = 53) received a 3-month group education and a 3-month coaching session. Physical examination and self-report questionnaires were used to collect both pre- and postintervention data on blood pressure, glucose, cholesterol, body mass index, smoking, depression, and health-related quality of life (HRQoL).
A total of 102 participants (85.0%) completed the 6-month study. Compared with the usual care group, the intervention group had a 5 mmHg greater reduction in systolic blood pressure (t = 2.01, p = .047), larger declines in glucose (t = -2.49, p = .015), cholesterol (t = -2.44, p = .017), body mass index (t = -2.58, p = .011), and depression (t = -2.05, p = .043), and better reports of HRQoL (t = 3.36, p = .001). No significant group differences in smoking behaviors were reported.
A 6-month community-based intervention in a CHD high-risk population improved disease-related risk factors, depression, and HRQoL. Results provide preliminary evidence for primary prevention of cardiovascular disease risk in a community high-risk population.
冠心病（CHD）的早期检测与管理已融入西方国家的许多社区卫生服务和初级医疗实践中。弗雷明汉冠心病风险评分已用于预测冠心病和死亡率近20年，并且在多种族人群中准确预测了冠心病事件风险。本研究的目的是评估一项为期6个月的社区干预对高危个体冠心病风险的影响。
从中国的两个社区招募了10年冠心病风险高的个体进行随机对照试验。干预组（n = 53）的个体接受了为期3个月的小组教育和为期3个月的辅导课程。通过体格检查和自我报告问卷收集干预前后关于血压、血糖、胆固醇、体重指数、吸烟、抑郁和健康相关生活质量（HRQoL）的数据。
共有102名参与者（85.0%）完成了为期6个月的研究。与常规护理组相比，干预组的收缩压降低幅度大5 mmHg（t = 2.01，p = 0.047），血糖（t = -2.49，p = 0.015）、胆固醇（t = -2.44，p = 0.017）、体重指数（t = -2.58，p = 0.011）和抑郁（t = -2.05，p = 0.043）下降幅度更大，HRQoL报告更好（t = 3.36，p = 0.001）。未报告吸烟行为方面的显著组间差异。
对冠心病高危人群进行为期6个月的社区干预改善了疾病相关危险因素、抑郁和HRQoL。研究结果为社区高危人群心血管疾病风险的一级预防提供了初步证据。
