School of Nursing and Midwifery, Western Sydney Local Health District, Sydney, NSW, Australia.
School of Nursing, Johns Hopkins University, Baltimore, MD, USA.
Contemp Nurse. 2021 Feb-Apr;57(1-2):80-98. doi: 10.1080/10376178.2021.1927774. Epub 2021 Jun 1.
Physical activity/exercise has consistently been shown to improve objective measures of functional capacity, enhance quality of life, improve coronary risk profile, and reduce mortality for individuals with coronary heart disease. Despite the gains achieved by those who attend cardiac rehabilitation (CR) many individuals fail to maintain lifestyle changes. The aims of this study were to evaluate the effectiveness of motivational interviewing as a strategy for promoting maintenance of cardiac risk factor modification in patients who had participated in standard, 6-week outpatient CR programs. In a randomized controlled trail, participants in usual care and intervention group (Motivational interviewing supplemental to a standard 6-week CR program) were followed up at 6-weeks and 12-months. The primary outcome was distance walked on the six-minute walk test (6MWT), used as both an indicator of functional capacity and habitual physical activity. Secondary outcomes included modifiable coronary risk factors (smoking, self-reported physical activity, waist circumference, body mass index and medication adherence), psychological status (depression, anxiety, stress, perceived cardiac control, perceived social support, exercise self-efficacy) and quality of life. Total 110 patients, usual care ( = 58) and intervention ( = 52), consented to participate in the study. Overall, demographic and clinical characteristics did not differ between groups at baseline. Motivational interviewing was no more likely to promote maintenance of cardiac risk factor modification (both primary and secondary outcomes) than a standard CR program alone. Both intervention and control groups maintained the gains achieved during CR at the 12-month follow-up except for weight loss. Although both groups maintained the gains achieved during CR for physical activity, there was no effect of the intervention on maintenance of cardiac risk factor modification on both primary and secondary outcomes.
身体活动/锻炼一直被证明可以改善功能能力的客观指标，提高生活质量，改善冠心病患者的冠状动脉风险状况，并降低死亡率。尽管参加心脏康复（CR）的人取得了很多进步，但许多人无法维持生活方式的改变。本研究的目的是评估动机访谈作为促进冠心病患者保持心脏危险因素改变的策略的有效性，这些患者已经参加了标准的 6 周门诊 CR 项目。在一项随机对照试验中，常规护理和干预组（在标准 6 周 CR 计划的基础上补充动机访谈）的参与者在 6 周和 12 个月时进行了随访。主要结果是六分钟步行试验（6MWT）上的步行距离，用于作为功能能力和习惯性体力活动的指标。次要结果包括可改变的冠心病危险因素（吸烟、自我报告的体力活动、腰围、体重指数和药物依从性）、心理状态（抑郁、焦虑、压力、感知心脏控制、感知社会支持、锻炼自我效能）和生活质量。共有 110 名患者，常规护理（ = 58）和干预（ = 52）同意参加研究。总体而言，两组在基线时的人口统计学和临床特征没有差异。动机访谈并不比单独的标准 CR 计划更有可能促进心脏危险因素改变的维持（主要和次要结果）。干预组和对照组在 12 个月的随访中都保持了 CR 期间取得的进展，除了体重减轻。尽管两组都保持了 CR 期间在体力活动方面取得的进展，但干预对主要和次要结果的心脏危险因素改变维持没有影响。
