Jiang Xiaofang, Zhao Jinlin, Wang Jieying, Xiong Weihao, Chen Yu, Deng Lamei
Nursing Department, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Puyan Community Health Service Center, Hangzhou, China.
J Prev (2022). 2025 May 8. doi: 10.1007/s10935-025-00850-1.
Cardiovascular diseases (CVDs), as the leading cause of mortality worldwide, impose substantial health-related costs. Lifestyle modification through education and counseling is a key strategy in CVD management. This study aimed to evaluate the impact of a nurse-led intervention on CVDs-related health costs and lifestyle habits among Chinese adults with CVDs. A quasi-experimental study was conducted among adults with CVDs assigned to either an intervention or control group. The intervention consisted of bi-monthly sessions over a six-month period, conducted in a hospital setting by trained registered nurses. Outcomes included CVD-related health costs and lifestyle behaviors (smoking, alcohol use, physical activity, and diet), measured at baseline, post-intervention, and six-month follow-up. Data were analyzed using Analysis of covariance (ANCOVA) to compare adjusted outcomes between groups, controlling for baseline values, age, gender, and BMI. The intervention group showed a higher proportion of non-smokers (from 65.2 to 74.1%) and participants with healthy diets (from 14.8 to 27.4%). At post-intervention, they had significantly fewer cigarettes smoked (9.6 ± 0.27, 95% CI: 9.07, 10.13 in intervention group vs. 11.1 ± 0.31, 95% CI: 10.49, 11.71 in control group; p = 0.024, η² = 0.020) and higher physical activity levels (264.4 ± 5.7, 95% CI: 253.23, 275.57 in intervention group vs. 229.2 ± 6.2, 95% CI: 217.05, 241.35 in control group; p = 0.032, η² = 0.018). At follow-up, they also showed significantly lower adjusted CVD-related health costs (17.2 ± 0.41, 95% CI: 16.4, 18.0 in intervention group vs. 20.7 ± 0.46, 95% CI: 19.8, 21.6 in control group; p = 0.029, η² = 0.018), sustained reductions in cigarette use (9.5 ± 0.26, 95% CI: 8.99, 10.01 in intervention group vs. 11.2 ± 0.32, 95% CI: 10.57, 11.83 in control group; p = 0.013, η² = 0.024), and increased physical activity (260.1 ± 5.4, 95% CI: 249.52, 270.68 in intervention group vs. 229.1 ± 6.4, 95% CI: 216.56, 241.64 in control group; p = 0.016, η² = 0.021). The nurse-led intervention may help promote lifestyle improvements and contribute to reductions in CVD-related health costs.
心血管疾病（CVDs）是全球主要的死亡原因，带来了巨大的健康相关成本。通过教育和咨询来改变生活方式是心血管疾病管理的关键策略。本研究旨在评估护士主导的干预措施对患有心血管疾病的中国成年人的心血管疾病相关健康成本和生活习惯的影响。对患有心血管疾病的成年人进行了一项准实验研究，将他们分为干预组或对照组。干预措施包括在六个月内每两个月进行一次课程，由经过培训的注册护士在医院环境中开展。结果包括心血管疾病相关健康成本和生活方式行为（吸烟、饮酒、身体活动和饮食），在基线、干预后和六个月随访时进行测量。使用协方差分析（ANCOVA）对数据进行分析，以比较各组调整后的结果，同时控制基线值、年龄、性别和体重指数。干预组中不吸烟者的比例更高（从65.2%升至74.1%），饮食健康的参与者比例也更高（从14.8%升至27.4%）。干预后，他们的吸烟量显著减少（干预组为9.6±0.27，95%置信区间：9.07，10.13；对照组为11.1±0.31，95%置信区间：10.49，11.71；p = 0.024，η² = 0.020），身体活动水平更高（干预组为264.4±5.7，95%置信区间：253.23，275.57；对照组为229.2±6.2，95%置信区间：217.05，241.35；p = 0.032，η² = 0.018）。在随访时，他们还显示出调整后的心血管疾病相关健康成本显著降低（干预组为17.2±0.41，95%置信区间：16.4，18.0；对照组为20.7±0.46，95%置信区间：19.8，21.6；p = 0.029，η² = 0.018），吸烟量持续减少（干预组为9.5±0.26，95%置信区间：8.99，10.01；对照组为11.2±0.32，95%置信区间：10.57，11.83；p = 0.013，η² = 0.
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