Pedersen Maria, Overgaard Dorthe, Boateng Takyiwa, Bennich Birgitte, Beck Anne Marie, Andersen Ingelise, Sibilitz Kirstine Lærum, Mairey Isabelle Pascale, Thygesen Lau Caspar, Petersen Rikke Agnete
J Cardiovasc Nurs. 2025;40(5):486-497. doi: 10.1097/JCN.0000000000001158. Epub 2024 Oct 11.
The positive effects of cardiac rehabilitation (CR) are well established; however, among older and vulnerable patients, nonattendance and dropout are prevalent problems.
The objective of this study is to explore if a 24-week peer-mentor intervention increases initial and long-term CR attendance. Secondary aims are whether peer-mentor intervention improves lifestyle (diet and physical activity) and psychological outcomes (self-efficacy, anxiety, depression, and quality of life) among older vulnerable patients with ischemic heart disease.
The study was designed as a 2-arm, single-center, parallel, 24-week, randomized controlled trial (RCT) with follow-up at 12 and 24 weeks. Patients were randomized at a ratio of 1:1 to receive either the peer-mentor intervention (in addition to standard CR) or standard CR along (control arm).
Between August 2021 and March 2023, 117 older, vulnerable patients were enrolled and randomized (59 randomized to peer-mentor intervention and 58 to usual care). The peer-mentor intervention significantly increased CR attendance. This applies to both initial participation in 1 CR session of physical training or dietary advice (78.0% vs 58.6%; P = .03), and long-term attendance in ≥50% dietary advice sessions (50.8% vs 27.6%; P = .01) and completed ≥50% (64.4% vs 41.4% P = .01) or ≥75% of the physical training sessions (59.3% vs 37.9%; P = .02). The study found no statistically significant effect on secondary outcomes.
Low CR attendance is a well-known problem, especially among older, vulnerable patients; however, we tested a low-cost, peer-mentor intervention that significantly increased both initial CR participation and long-term attendance in CR sessions in this group of patients.
心脏康复（CR）的积极效果已得到充分证实；然而，在老年和脆弱患者中，不参加和退出是普遍存在的问题。
本研究的目的是探讨为期24周的同伴辅导干预是否能提高心脏康复的初始和长期参与率。次要目的是同伴辅导干预是否能改善患有缺血性心脏病的老年脆弱患者的生活方式（饮食和体育活动）和心理结果（自我效能感、焦虑、抑郁和生活质量）。
该研究设计为双臂、单中心、平行、为期24周的随机对照试验（RCT），并在12周和24周时进行随访。患者按1:1的比例随机分组，接受同伴辅导干预（除标准心脏康复外）或仅接受标准心脏康复（对照组）。
在2021年8月至2023年3月期间，117名老年脆弱患者被纳入并随机分组（59名随机接受同伴辅导干预，58名接受常规护理）。同伴辅导干预显著提高了心脏康复的参与率。这适用于最初参加1次体育训练或饮食建议的心脏康复课程（78.0%对58.6%；P = 0.03），以及长期参加≥50%的饮食建议课程（50.8%对27.6%；P = 0.01），并完成≥50%（64.4%对41.4%，P = 0.01）或≥75%的体育训练课程（59.3%对37.9%；P = 0.02）。该研究发现对次要结果没有统计学上的显著影响。
心脏康复参与率低是一个众所周知的问题，尤其是在老年脆弱患者中；然而，我们测试了一种低成本的同伴辅导干预措施，该措施显著提高了这组患者心脏康复的初始参与率和长期课程参与率。
