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“让我恢复生机”:射血分数保留的心力衰竭成年人参加运动训练临床试验的纵向认知。

'Working me to life': longitudinal perceptions from adults with heart failure with preserved ejection fraction enrolled in an exercise training clinical trial.

机构信息

College of Nursing, University of Nebraska Medical Center, Omaha, NE.

Division of Cardiovascular Medicine, College of Medicine, University of Nebraska Medical Center, Omaha, NE.

出版信息

Eur J Cardiovasc Nurs. 2024 Oct 21;23(7):763-770. doi: 10.1093/eurjcn/zvae049.

Abstract

AIMS

Adults with heart failure with preserved ejection fraction (HFpEF) responded more favourably to an exercise intervention compared with those with reduced ejection fraction. This study explores factors that contributed to this response, focusing on the qualitative perceptions of adults with HFpEF enrolled in an exercise intervention.

METHODS AND RESULTS

This qualitative descriptive study is a secondary analysis of longitudinal interviews collected at 3, 6, 12, and 18 months from participants with HFpEF enrolled in a randomized controlled trial testing an intervention to promote adherence to exercise. We included participants with at least two interviews. Interviews were examined across and within participants and time points using thematic analysis. Analyses included 67 interviews from 21 adults with HFpEF enrolled in the intervention arm. The sample consisted of 52% (11/21) males and over 47% (10/21) non-White participants. Mean age at enrolment was 63.7 ± 9.9 years. We identified four major themes: (1) overcoming negative attitudes, barriers, and injury, (2) motivations to exercise, (3) exercise-the panacea for HFpEF symptoms and quality of life, and (4) advice for others with HFpEF.

CONCLUSION

Our findings suggest that for many adults with HFpEF, initial hesitancy, fear, and negative attitudes about exercise can be overcome. Exercise coaching using social cognitive constructs, medical fitness centre memberships, and heart rate self-monitoring are successful strategies of engaging adults with HFpEF in long-term unsupervised exercise training.

REGISTRATION

ClinicalTrials.gov, NCT01658670.

摘要

目的

射血分数保留的心力衰竭(HFpEF)成人对运动干预的反应优于射血分数降低的心力衰竭成人。本研究探讨了导致这种反应的因素,重点是参与运动干预的 HFpEF 成人的定性认知。

方法和结果

这是一项对随机对照试验中收集的纵向访谈进行的二次分析,该试验测试了促进锻炼依从性的干预措施。我们纳入了至少有两次访谈的参与者。使用主题分析对参与者和时间点进行了跨访谈和内访谈分析。分析包括 21 名参与干预组的 HFpEF 成人的 67 次访谈。样本由 52%(11/21)男性和超过 47%(10/21)非白人参与者组成。登记时的平均年龄为 63.7±9.9 岁。我们确定了四个主要主题:(1)克服消极态度、障碍和损伤,(2)锻炼动机,(3)锻炼——HFpEF 症状和生活质量的万能药,(4)为其他 HFpEF 患者提供建议。

结论

我们的研究结果表明,对于许多 HFpEF 成人来说,最初对运动的犹豫、恐惧和消极态度是可以克服的。使用社会认知结构的运动指导、医疗健身中心会员资格和心率自我监测是使 HFpEF 成人参与长期非监督运动训练的成功策略。

登记

ClinicalTrials.gov,NCT01658670。

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