混合式自我护理教育项目对慢性病患者饮食质量和心血管风险的可持续影响：一项随机对照试验。

Sustainable effects of a hybrid self-care education program on diet quality and cardiovascular risk in patients with chronic conditions: A randomized controlled trial.

作者信息

Izadirad Hossein, Jangizahi Zahra

机构信息

Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran.

Research Center, Zahedan University of Medical Sciences, Zahedan, Iran.

出版信息

Int J Cardiol Cardiovasc Risk Prev. 2025 Jul 31;27:200479. doi: 10.1016/j.ijcrp.2025.200479. eCollection 2025 Dec.

DOI:10.1016/j.ijcrp.2025.200479

PMID:40809092

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12340565/

Abstract

BACKGROUND

Inadequately managed chronic diseases heighten cardiovascular risk. Improved dietary habits are crucial for risk reduction and enhanced patient health. This study evaluated the sustained impact of a hybrid self-care education program on diet quality and cardiovascular risk in patients with chronic conditions.

METHODS

In this 2023 randomized controlled trial in Saravan, Iran, 150 patients with chronic conditions were enrolled. Participants were randomly allocated to an intervention group (n = 75) or a control group (n = 75). Data were collected using a self-care nutrition questionnaire and the Mini-EAT. The intervention group received a one-month hybrid self-care education program integrating the Teach-Back method with digital education, followed by monthly follow-ups. Data were analyzed using SPSS version 26 with repeated measures ANOVA, one-way ANOVA, independent t-tests, and chi-square tests (statistical significance: p < 0.05). Follow-up assessments occurred at 3 and 12 months post-intervention.

RESULTS

Post-intervention, nutritional self-care scores in the intervention group increased significantly from baseline (11.90) to 3 months (24.12) and remained stable at 12 months (23.74; p < 0.001). No comparable change occurred in controls. Diet quality improved markedly: the proportion with unhealthy diets decreased from 98.67 % to 49.34 %, while adherence to healthy diets rose from 0 % to 13.33 % (p < 0.001). At the 12-month follow-up, statistically significant reductions were observed across all key cardiovascular risk metrics: systolic blood pressure decreased from 142.21 mmHg to 132.22 mmHg, diastolic blood pressure from 104.70 mmHg to 92.16 mmHg, fasting blood glucose from 212.66 mg/dL to 151.48 mg/dL, and BMI from 27.91 kg/m to 25.32 kg/m (all p < 0.001).

CONCLUSION

The integrated Teach-Back and digital education intervention produced sustained improvements in nutritional self-care, diet quality, and cardiovascular risk factors among patients with chronic conditions. Effect durability at 12 months underscores the value of ongoing follow-up in educational strategies. These findings support integrating digital education into health promotion programs to reinforce self-care behaviors and improve clinical outcomes.

摘要

背景

慢性病管理不善会增加心血管疾病风险。改善饮食习惯对于降低风险和增进患者健康至关重要。本研究评估了混合式自我护理教育项目对慢性病患者饮食质量和心血管疾病风险的持续影响。

方法

在2023年于伊朗萨拉万开展的这项随机对照试验中，招募了150名慢性病患者。参与者被随机分配到干预组（n = 75）或对照组（n = 75）。使用自我护理营养问卷和Mini-EAT收集数据。干预组接受了为期一个月的混合式自我护理教育项目，该项目将反馈教学法与数字教育相结合，随后进行每月一次的随访。使用SPSS 26版软件，通过重复测量方差分析、单因素方差分析、独立样本t检验和卡方检验对数据进行分析（统计学显著性：p < 0.05）。在干预后3个月和12个月进行随访评估。

结果

干预后，干预组的营养自我护理得分从基线时的11.90显著提高到3个月时的24.12，并在12个月时保持稳定（23.74；p < 0.001）。对照组未出现类似变化。饮食质量显著改善：不健康饮食的比例从98.67%降至49.34%，而健康饮食的依从率从0%升至13.33%（p < 0.001）。在12个月的随访中，所有关键心血管疾病风险指标均出现统计学显著下降：收缩压从142.21 mmHg降至132.22 mmHg，舒张压从104.70 mmHg降至92.16 mmHg，空腹血糖从212.66 mg/dL降至151.48 mg/dL，体重指数从27.91 kg/m降至25.32 kg/m（均p < 0.001）。