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基于网络的护理干预对冠状动脉血运重建术后老年人身体活动的促进作用:混合方法试点研究方案

Web-Based Nursing Intervention to Promote Physical Activity Among Older Adults After Coronary Revascularization: Protocol for Mixed Method Pilot Study.

作者信息

Lavoie Audrey, Dubé Véronique

机构信息

Faculty of Nursing, Université de Montréal, Montreal, QC, Canada.

Marguerite-d'Youville Research Chair on Humanistic Nursing Interventions, Université de Montréal, Montreal, QC, Canada.

出版信息

JMIR Res Protoc. 2025 May 21;14:e67678. doi: 10.2196/67678.

Abstract

BACKGROUND

Given the high prevalence of coronary heart disease among older adults and aging populations, there is a need for secondary prevention interventions to help older adults become more physically active. Web-based interventions could be considered for this purpose, knowing that internet use is growing rapidly among older adults. In addition, since older adults would appreciate developing a trusting relationship with a nurse, web-based interventions should include this support, which is not widely observed in the literature.

OBJECTIVE

This study aims to evaluate a web-based nursing intervention aimed at promoting physical activity in people 65 years and older with coronary heart disease.

METHODS

A web-based nursing intervention was developed according to the Intervention Mapping framework in collaboration with a team of health care professionals (n=5) and based on the needs of older adults (n=10). The 7-week intervention (1 session per week) aims to support older adults living with coronary artery disease in resuming, maintaining, or increasing their level of physical activity after coronary bypass surgery or percutaneous coronary intervention. The intervention offers educational content on coronary heart disease and physical activity, suggestions for physical activity, reflective activities, case histories of older adults who have experienced different journeys, an electronic physical activity diary to track progress, and support from a nurse through feedback to increase knowledge, motivation, and sense of self-efficacy. The preliminary effects and impacts of the intervention will be assessed through a mixed method pilot study with a sequential explanatory design. First, a single-group pre-post test will be used to assess the intervention's preliminary effects on physical activity (electronic journal), quality of life (36-Item Short Form Health Survey version 2), knowledge (quiz), motivation, and self-efficacy (visual analog scale) of 30 older adults living with coronary heart disease, as well as the feasibility of the intervention. Second, a descriptive qualitative design will use semistructured interviews to assess the intervention's impacts as perceived by 8-12 older adults and its acceptability. Quantitative data on the effects of the intervention will be integrated with the collection and analysis of qualitative data to assess the impact perceived by older adults, using matrices. Nonparametric statistics and a thematic analysis will be produced. A joint display will be used to integrate mixed data.

RESULTS

The results of this study will provide insight into the preliminary evaluation of a web-based nursing intervention to support older adults living with coronary heart disease as they increase their physical activity levels. The recruitment commenced in June 2024, and data collection should be completed by June 2025.

CONCLUSIONS

With the potential to promote older adults' health, this study could guide the development of new interventions to meet the needs of an aging population.

TRIAL REGISTRATION

ClinicalTrials.gov NCT06197347; https://clinicaltrials.gov/study/NCT06197347.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/67678.

摘要

背景

鉴于冠心病在老年人和老龄人口中的高患病率,需要采取二级预防干预措施来帮助老年人增加身体活动。考虑到老年人互联网使用迅速增长,可为此目的考虑基于网络的干预措施。此外,由于老年人会重视与护士建立信任关系,基于网络的干预措施应包括这种支持,而这在文献中并未广泛提及。

目的

本研究旨在评估一项基于网络的护理干预措施,该措施旨在促进65岁及以上冠心病患者的身体活动。

方法

根据干预映射框架,与一组医疗保健专业人员(n = 5)合作并基于老年人(n = 10)的需求,开发了一项基于网络的护理干预措施。为期7周的干预(每周1次)旨在支持患有冠状动脉疾病的老年人在冠状动脉搭桥手术或经皮冠状动脉介入治疗后恢复、维持或提高其身体活动水平。该干预提供有关冠心病和身体活动的教育内容、身体活动建议、反思活动、经历不同历程的老年人的案例、用于跟踪进展的电子身体活动日记,以及护士通过反馈提供的支持,以增加知识、动力和自我效能感。将通过采用序列解释性设计的混合方法试点研究来评估该干预的初步效果和影响。首先,将使用单组前后测试来评估干预对30名患有冠心病的老年人的身体活动(电子日记)、生活质量(36项简短健康调查第2版)、知识(测验)、动力和自我效能(视觉模拟量表)的初步效果,以及干预的可行性。其次,描述性定性设计将使用半结构化访谈来评估8至12名老年人所感知到的干预影响及其可接受性。将使用矩阵将关于干预效果的定量数据与定性数据的收集和分析相结合,以评估老年人所感知到的影响。将进行非参数统计和主题分析。将使用联合展示来整合混合数据。

结果

本研究结果将为基于网络的护理干预措施的初步评估提供见解,该干预措施旨在支持患有冠心病的老年人提高其身体活动水平。招募工作于2024年6月开始,数据收集应于2025年6月完成。

结论

本研究有潜力促进老年人健康,可为满足老龄人口需求的新干预措施的开发提供指导。

试验注册

ClinicalTrials.gov NCT06197347;https://clinicaltrials.gov/study/NCT06197347。

国际注册报告识别码(IRRID):DERR1-10.2196/67678。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dac6/12138288/c868a81f0454/resprot_v14i1e67678_fig1.jpg

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