Carlsson R, Lindberg G, Westin L, Israelsson B
Department of Medicine, Central Hospital, Karlstad, Sweden.
Heart. 1997 Mar;77(3):256-9. doi: 10.1136/hrt.77.3.256.
To examine the ability of a secondary prevention programme to improve the lifestyle in myocardial infarction patients aged 50-70 years.
Habitual physical activity, food habits, and smoking habits were assessed from questionnaires at admission to hospital and at the one year follow up. Initially, all patients were invited to join an exercise programme and were informed about cardiovascular risk factors. Four weeks after discharge from the hospital, 87 patients were randomised to follow up at the coronary prevention unit by a special trained nurse (the intervention group), and 81 to follow up by their general practitioners (the usual care group). After randomisation, the intervention group was educated about the effects of smoking cessation, dietary management, and regular physical activity. The intervention group also participated in a physical training programme two to three times weekly for 10-12 weeks.
89% of the patients referred to the intervention group improved their food habits compared with 62% of the patients referred to the usual care group (P = 0.008). Furthermore, 50% of the smokers referred to the intervention group stopped smoking compared to 29% in the usual care group (P = 0.09). Changes in physical activity did not differ between the groups.
This secondary prevention programme based on a nurse rehabilitator was successful in improving food habits in patients with acute myocardial infarction. Initiating the smoking cessation programme during the hospital stay followed by repeated counselling during follow up might have improved the results. The exercise programme had no advantage in supporting physical activity compared to usual care.
研究二级预防项目改善50至70岁心肌梗死患者生活方式的能力。
通过问卷调查在入院时及随访一年时评估患者的习惯性身体活动、饮食习惯和吸烟习惯。最初，邀请所有患者参加一项运动项目，并告知他们心血管危险因素。出院四周后，87名患者被随机分配由一名经过专门培训的护士在冠心病预防科进行随访（干预组），81名患者由他们的全科医生进行随访（常规护理组）。随机分组后，对干预组患者进行戒烟、饮食管理和规律身体活动效果方面的教育。干预组还每周参加两到三次体育训练项目，为期10至12周。
干预组中89%的患者改善了饮食习惯，而常规护理组中这一比例为62%（P = 0.008）。此外，干预组中50%的吸烟者戒烟，常规护理组为29%（P = 0.09）。两组间身体活动的变化无差异。
这项基于护士康复师的二级预防项目成功改善了急性心肌梗死患者的饮食习惯。在住院期间启动戒烟项目并在随访期间反复进行咨询可能会改善结果。与常规护理相比，运动项目在促进身体活动方面并无优势。
