中国冠心病门诊患者家庭心脏康复计划依从性的预测因素
Predictors of adherence to home-based cardiac rehabilitation program among coronary artery disease outpatients in China.
作者信息
Ge Cheng, Ma Jing, Xu Yong, Shi Ya-Jun, Zhao Cheng-Hui, Gao Ling, Bai Jing, Wang Yu, Sun Zhi-Jun, Guo Jun, Chen Yun-Dai
机构信息
Department of Cardiology, the First Medical Center of Chinese PLA General Hospital, Beijing, China.
出版信息
J Geriatr Cardiol. 2019 Oct;16(10):749-755. doi: 10.11909/j.issn.1671-5411.2019.10.003.
BACKGROUND
Cardiac rehabilitation (CR) has proven beneficial for patients with coronary artery disease. However, adherence to CR programs is the key to the health improvement in those patients. Identifying predictors for adherence, which is very much unknown in China, would be valuable for effective rehabilitation. This study aims to determine the adherence to home-based CR programs in Chinese coronary artery disease patients and determine predictors of adherence.
METHODS
The current study included 1033 outpatients with coronary heart disease in the First Medical Center of Chinese PLA General Hospital in Beijing from July 2015 to June 2017. Participants were given an exercise prescription and took part in home-based exercise training lasting for 3-24 months. A questionnaire was used to evaluate the completion of the CR program, understanding of the program, motivation of the patients, and family/peer support.
RESULTS
Two thirds of the patients adhered well to the home-based CR program. Elder patients (≥ 65-year-old) adhere to the program better, while men adhered better than women. Patients who used to exercise ( = 6.756, < 0.001), understood the program ( = 0.078, = 0.002), with stronger motivation to participate ( = 0.376, < 0.001), and received better family support ( = 0.487, < 0.001) also adhere better to the program.
CONCLUSIONS
Understanding the program, self-motivation of patients, and family support help to keep patients engaged in a home-based CR program. Improvement of family support by educating both patients and families may be helpful in improving adherence to home-based CR programs.
背景
心脏康复（CR）已被证明对冠心病患者有益。然而，坚持心脏康复计划是这些患者健康改善的关键。在中国，识别坚持的预测因素仍知之甚少，而这对于有效的康复治疗具有重要价值。本研究旨在确定中国冠心病患者对家庭心脏康复计划的坚持情况，并确定坚持的预测因素。
方法
本研究纳入了2015年7月至2017年6月在北京解放军总医院第一医学中心就诊的1033例冠心病门诊患者。参与者接受了运动处方，并参加了为期3 - 24个月的家庭运动训练。使用问卷调查来评估心脏康复计划的完成情况、对该计划的理解、患者的积极性以及家庭/同伴支持。
结果
三分之二的患者很好地坚持了家庭心脏康复计划。老年患者（≥65岁）对该计划的坚持更好，男性比女性坚持得更好。过去经常锻炼的患者（ = 6.756， < 0.001）、理解该计划的患者（ = 0.078， = 0.002）、参与积极性更强的患者（ = 0.376， < 0.001）以及获得更好家庭支持的患者（ = 0.487， < 0.001）对该计划的坚持也更好。
结论
对计划的理解、患者的自我激励以及家庭支持有助于患者坚持家庭心脏康复计划。通过对患者及其家庭进行教育来改善家庭支持，可能有助于提高对家庭心脏康复计划的坚持率。
Zotero 插件