Department of Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
Center of Expertise Urban Vitality, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands.
Age Ageing. 2021 May 5;50(3):936-943. doi: 10.1093/ageing/afaa283.
lifestyle-related secondary prevention reduces cardiac events and is recommended irrespective of age. However, motivation may be influenced by age and disease progression.
to explore older cardiac patients' perspectives toward lifestyle-related secondary prevention after a hospital admission.
a generic qualitative design was used. Semi-structured interviews were performed with cardiac patients ≥ 70 years within 3 months after a hospital admission. The interview guide was based on the Attitudes, Social influence and self-Efficacy (ASE) model. All interviews were analysed using thematic analysis.
eight themes emerged which were linked to the determinants of the ASE-model. The three themes (i) Perspectives are determined by general health and habits, (ii) feeling the threat as a motivator and (iii) balancing between health benefits and quality of life (QoL), were linked to attitude. Regarding social influence, the themes (iv) feeling both encouraged and hindered by family members, and (v) the healthcare professional says so, were identified. For the self-efficacy determinant, (vi) experiences from previous lifestyle changes, (vii) integrating advice in daily life and (viii) feeling limited by functional impairments, emerged as themes.
most older cardiac patients made no lifestyle modifications after the last hospital admission and balanced possible benefits against their QoL. Functional impairments frequently limit implementation, in particular of physical activity. Patients' preferences and patient-centred outcomes focusing on QoL and functional independence may be the starting point when healthcare professionals discuss lifestyle modification in older patients. The involvement of family members may help patients to integrate lifestyle-related secondary prevention in daily life.
与生活方式相关的二级预防可减少心脏事件的发生，无论年龄大小都推荐进行这种预防。然而，动机可能会受到年龄和疾病进展的影响。
探讨老年心脏患者在住院后对与生活方式相关的二级预防的看法。
采用通用定性设计。在住院后 3 个月内，对年龄≥70 岁的心脏患者进行半结构式访谈。访谈指南基于态度、社会影响和自我效能（ASE）模型。使用主题分析对所有访谈进行分析。
出现了 8 个主题，这些主题与 ASE 模型的决定因素有关。三个主题（i）观点取决于总体健康状况和习惯，（ii）感到威胁是一个激励因素，（iii）在健康益处和生活质量（QoL）之间取得平衡，与态度有关。关于社会影响，确定了（iv）感受到家庭成员的鼓励和阻碍，以及（v）医疗保健专业人员这么说这两个主题。对于自我效能决定因素，出现了（vi）以前生活方式改变的经验，（vii）将建议融入日常生活，以及（viii）因功能障碍而感到受限这三个主题。
大多数老年心脏患者在上次住院后没有进行生活方式的改变，而是在可能的益处和他们的生活质量之间取得平衡。功能障碍经常限制实施，特别是体力活动的实施。患者的偏好和以患者为中心的注重生活质量和功能独立性的结果可能是医护人员在老年患者中讨论生活方式改变的起点。家庭成员的参与可以帮助患者将与生活方式相关的二级预防融入日常生活中。
