Susan J. Pressler, PhD, RN Director, Center for Enhancing Quality of Life in Chronic Illness, and Professor and Sally Reahard Chair, Indiana University School of Nursing, Indianapolis. Bruno Giordani, PhD Professor, Neuropsychology Program, Department of Psychiatry, University of Michigan School of Medicine, Ann Arbor. Marita Titler, PhD, RN Professor, Rhetaugh Dumas Endowed Chair, and Department Chair, Systems, Populations and Leadership, University of Michigan School of Nursing, Ann Arbor. Irmina Gradus-Pizlo, MD Clinical Professor, Division of Cardiology, University of California, Irvine. Dean Smith, PhD Professor and Dean, School of Public Health, Louisiana State University Health Sciences Center, New Orleans. Susan G. Dorsey, PhD, RN Professor and Department Chair, Department of Pain and Transitional Symptom Science, University of Maryland School of Nursing, Baltimore. Sujuan Gao, PhD Professor, Department of Biostatistics, Indiana University School of Medicine, Indianapolis. Miyeon Jung, PhD, RN Assistant Professor, Indiana University School of Nursing, Indianapolis.
J Cardiovasc Nurs. 2018 Jul/Aug;33(4):344-355. doi: 10.1097/JCN.0000000000000463.
Memory loss is an independent predictor of mortality among heart failure patients. Twenty-three percent to 50% of heart failure patients have comorbid memory loss, but few interventions are available to treat the memory loss. The aims of this 3-arm randomized controlled trial were to (1) evaluate efficacy of computerized cognitive training intervention using BrainHQ to improve primary outcomes of memory and serum brain-derived neurotrophic factor levels and secondary outcomes of working memory, instrumental activities of daily living, and health-related quality of life among heart failure patients; (2) evaluate incremental cost-effectiveness of BrainHQ; and (3) examine depressive symptoms and genomic moderators of BrainHQ effect.
A sample of 264 heart failure patients within 4 equal-sized blocks (normal/low baseline cognitive function and gender) will be randomly assigned to (1) BrainHQ, (2) active control computer-based crossword puzzles, and (3) usual care control groups. BrainHQ is an 8-week, 40-hour program individualized to each patient's performance. Data collection will be completed at baseline and at 10 weeks and 4 and 8 months. Descriptive statistics, mixed model analyses, and cost-utility analysis using intent-to-treat approach will be computed.
This research will provide new knowledge about the efficacy of BrainHQ to improve memory and increase serum brain-derived neurotrophic factor levels in heart failure. If efficacious, the intervention will provide a new therapeutic approach that is easy to disseminate to treat a serious comorbid condition of heart failure.
记忆丧失是心力衰竭患者死亡的独立预测因素。23%至 50%的心力衰竭患者伴有记忆丧失的合并症，但很少有干预措施可用于治疗记忆丧失。本三项随机对照试验的目的是：（1）评估使用 BrainHQ 的计算机认知训练干预对改善心力衰竭患者的记忆和血清脑源性神经营养因子水平的主要结局以及工作记忆、日常工具性活动和健康相关生活质量的次要结局的疗效；（2）评估 BrainHQ 的增量成本效益；（3）检查抑郁症状和基因组对 BrainHQ 效果的调节作用。
将 264 名心力衰竭患者分为 4 个相等大小的组（正常/低基线认知功能和性别），随机分配到（1）BrainHQ、（2）主动控制电脑填字游戏和（3）常规护理对照组。BrainHQ 是一个为期 8 周、40 小时的个性化计划，针对每位患者的表现进行调整。数据将在基线和 10 周、4 个月和 8 个月时收集。将计算描述性统计、混合模型分析和使用意向治疗方法的成本效用分析。
这项研究将提供关于 BrainHQ 改善心力衰竭患者记忆和增加血清脑源性神经营养因子水平的疗效的新知识。如果有效，该干预措施将提供一种新的治疗方法，易于传播以治疗心力衰竭的严重合并症。
