Keessen Paul, van Duijvenbode Ingrid Cd, Latour Corine Hm, Kraaijenhagen Roderik A, Janssen Veronica R, Jørstad Harald T, Scholte Op Reimer Wilma Jm, Visser Bart
Centre of Expertise Urban Vitality, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, Netherlands.
Cardiovitaal Cardiac Rehabilitation, Amsterdam, Netherlands.
JMIR Cardio. 2022 May 25;6(1):e34974. doi: 10.2196/34974.
Remote coaching might be suited for providing information and support to patients with coronary artery disease (CAD) in the vulnerable phase between hospital discharge and the start of cardiac rehabilitation (CR).
The goal of the research was to explore and summarize information and support needs of patients with CAD and develop an early remote coaching program providing tailored information and support.
We used the intervention mapping approach to develop a remote coaching program. Three steps were completed in this study: (1) identification of information and support needs in patients with CAD, using an exploratory literature study and semistructured interviews, (2) definition of program objectives, and (3) selection of theory-based methods and practical intervention strategies.
Our exploratory literature study (n=38) and semistructured interviews (n=17) identified that after hospital discharge, patients with CAD report a need for tailored information and support about CAD itself and the specific treatment procedures, medication and side effects, physical activity, and psychological distress. Based on the preceding steps, we defined the following program objectives: (1) patients gain knowledge on how CAD and revascularization affect their bodies and health, (2) patients gain knowledge about medication and side effects and adhere to their treatment plan, (3) patients know which daily physical activities they can and can't do safely after hospital discharge and are physically active, and (4) patients know the psychosocial consequences of CAD and know how to discriminate between harmful and harmless body signals. Based on the preceding steps, a remote coaching program was developed with the theory of health behavior change as a theoretical framework with behavioral counseling and video modeling as practical strategies for the program.
This study shows that after (acute) cardiac hospitalization, patients are in need of information and support about CAD and revascularization, medication and side effects, physical activity, and psychological distress. In this study, we present the design of an early remote coaching program based on the needs of patients with CAD. The development of this program constitutes a step in the process of bridging the gap from hospital discharge to start of CR.
远程指导可能适用于在出院至心脏康复（CR）开始的脆弱阶段为冠心病（CAD）患者提供信息和支持。
本研究的目的是探索和总结CAD患者的信息和支持需求，并制定一个提供量身定制的信息和支持的早期远程指导项目。
我们采用干预映射方法来制定远程指导项目。本研究完成了三个步骤：（1）通过探索性文献研究和半结构化访谈确定CAD患者的信息和支持需求；（2）确定项目目标；（3）选择基于理论的方法和实际干预策略。
我们的探索性文献研究（n = 38）和半结构化访谈（n = 17）表明，出院后，CAD患者报告需要有关CAD本身、具体治疗程序、药物及副作用、身体活动和心理困扰的量身定制的信息和支持。基于上述步骤，我们确定了以下项目目标：（1）患者了解CAD和血运重建如何影响他们的身体和健康；（2）患者了解药物及副作用并遵守治疗计划；（3）患者知道出院后哪些日常身体活动可以安全进行，哪些不能，并积极进行身体活动；（4）患者了解CAD的心理社会后果，并知道如何区分有害和无害的身体信号。基于上述步骤，以健康行为改变理论为理论框架，以行为咨询和视频示范为项目的实际策略，制定了一个远程指导项目。
本研究表明，在（急性）心脏住院治疗后，患者需要有关CAD和血运重建、药物及副作用、身体活动和心理困扰的信息和支持。在本研究中，我们根据CAD患者的需求展示了一个早期远程指导项目的设计。该项目的开发是弥合从出院到开始CR之间差距过程中的一个步骤。
