Sriram Premkumar, Lakshmi Ramamoorthy, Ajith A Pillai
{"title":"护士主导的心脏康复对冠状动脉介入治疗后患者行为和生理参数的影响:一项随机对照试验。","authors":"Sriram Premkumar, Lakshmi Ramamoorthy, Ajith A Pillai","doi":"10.4103/jfcm.jfcm_315_21","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Coronary artery disease, one of the leading causes of mortality and morbidity globally, is a major burden on healthcare resources. Cardiovascular rehabilitation is highly recommended for the early recovery of patients with Ischemic heart disease by improving the functional capacity and decreasing disease progression. A randomized controlled trial was conducted to assess the effect of nurse-led cardiac rehabilitation (CR) on behavioural parameters.</p><p><strong>Materials and methods: </strong>Sixty-two adult patients who underwent percutaneous coronary intervention (PCI) were randomised to two groups to assess the effect of nurse-led cardiac rehabilitation (CR) on behavioural parameters, including adherence to drugs, cardiac diet, lifestyle changes, and selected physiological parameters. The intervention group had nurse-led individualized discharge counseling and clinical follow-up by telephone, whereas the control group received usual care. The comparisons between the control and intervention groups were made using independent Student's <i>t</i>-test or Mann-Whitney U test as appropriate. Pre-test and post-test scores were compared using paired <i>t</i>-test; all tests performed at 5% significance level.</p><p><strong>Results: </strong>Participants in the intervention group presented with moderate to good smoking cessation, improved adherence to drugs (<i>P</i> < 0.0001), physically active lifestyle in 90.3 versus 45.2% (<i>P</i> < 0.0001), adherence to dietary changes, and improved healthcare satisfaction (<i>P</i> < 0.0001). There was also a significant reduction in triglycerides level in the intervention group at 62.51 versus 20.12 mg/dl in the control arm with (<i>P</i> < 0.05), and better controlled physiological indices, including a reduction in systolic blood pressure of 1.54 vs-7.12 mmHg (<i>P</i> = 0.003), bodyweight reduction of 2.48 kg versus-0.09 kg (<i>P</i> < 0.0001) and body mass index of 0.9 versus-0.05 (<i>P</i> < 0.0001).</p><p><strong>Conclusion: </strong>Personalised, nurse-led CR significantly improved the participants adherence to healthy lifestyle behaviors and decreased the cardiac risk factors in patients with coronary artery disease.</p>","PeriodicalId":46862,"journal":{"name":"Journal of Family and Community Medicine","volume":"29 1","pages":"17-23"},"PeriodicalIF":1.9000,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e8/e0/JFCM-29-17.PMC8802728.pdf","citationCount":"2","resultStr":"{\"title\":\"Impact of nurse-led cardiac rehabilitation on patient's behavioral and physiological parameters after a coronary intervention: A pilot randomized controlled trial.\",\"authors\":\"Sriram Premkumar, Lakshmi Ramamoorthy, Ajith A Pillai\",\"doi\":\"10.4103/jfcm.jfcm_315_21\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Coronary artery disease, one of the leading causes of mortality and morbidity globally, is a major burden on healthcare resources. Cardiovascular rehabilitation is highly recommended for the early recovery of patients with Ischemic heart disease by improving the functional capacity and decreasing disease progression. A randomized controlled trial was conducted to assess the effect of nurse-led cardiac rehabilitation (CR) on behavioural parameters.</p><p><strong>Materials and methods: </strong>Sixty-two adult patients who underwent percutaneous coronary intervention (PCI) were randomised to two groups to assess the effect of nurse-led cardiac rehabilitation (CR) on behavioural parameters, including adherence to drugs, cardiac diet, lifestyle changes, and selected physiological parameters. The intervention group had nurse-led individualized discharge counseling and clinical follow-up by telephone, whereas the control group received usual care. The comparisons between the control and intervention groups were made using independent Student's <i>t</i>-test or Mann-Whitney U test as appropriate. Pre-test and post-test scores were compared using paired <i>t</i>-test; all tests performed at 5% significance level.</p><p><strong>Results: </strong>Participants in the intervention group presented with moderate to good smoking cessation, improved adherence to drugs (<i>P</i> < 0.0001), physically active lifestyle in 90.3 versus 45.2% (<i>P</i> < 0.0001), adherence to dietary changes, and improved healthcare satisfaction (<i>P</i> < 0.0001). There was also a significant reduction in triglycerides level in the intervention group at 62.51 versus 20.12 mg/dl in the control arm with (<i>P</i> < 0.05), and better controlled physiological indices, including a reduction in systolic blood pressure of 1.54 vs-7.12 mmHg (<i>P</i> = 0.003), bodyweight reduction of 2.48 kg versus-0.09 kg (<i>P</i> < 0.0001) and body mass index of 0.9 versus-0.05 (<i>P</i> < 0.0001).</p><p><strong>Conclusion: </strong>Personalised, nurse-led CR significantly improved the participants adherence to healthy lifestyle behaviors and decreased the cardiac risk factors in patients with coronary artery disease.</p>\",\"PeriodicalId\":46862,\"journal\":{\"name\":\"Journal of Family and Community Medicine\",\"volume\":\"29 1\",\"pages\":\"17-23\"},\"PeriodicalIF\":1.9000,\"publicationDate\":\"2022-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e8/e0/JFCM-29-17.PMC8802728.pdf\",\"citationCount\":\"2\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Family and Community Medicine\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.4103/jfcm.jfcm_315_21\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2022/1/19 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Family and Community Medicine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.4103/jfcm.jfcm_315_21","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2022/1/19 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
引用次数: 2
摘要
背景:冠状动脉疾病是全球死亡率和发病率的主要原因之一,是卫生保健资源的主要负担。心血管康复是缺血性心脏病患者早期康复的重要手段,可以改善患者的功能,减少病情的发展。通过一项随机对照试验来评估护士主导的心脏康复(CR)对行为参数的影响。材料和方法:将62例经皮冠状动脉介入治疗(PCI)的成年患者随机分为两组,评估护士主导的心脏康复(CR)对行为参数的影响,包括药物依从性、心脏饮食、生活方式改变和选定的生理参数。干预组接受护士个体化出院咨询和电话临床随访,对照组接受常规护理。对照组和干预组之间的比较酌情采用独立的学生t检验或Mann-Whitney U检验。采用配对t检验比较前测和后测得分;所有测试均在5%显著性水平下进行。结果:干预组的参与者表现为中度至良好戒烟,改善药物依从性(P < 0.0001),体力活动生活方式(90.3% vs 45.2%),坚持改变饮食,改善医疗保健满意度(P < 0.0001)。干预组的甘油三酯水平也显著降低,为62.51 mg/dl,而对照组为20.12 mg/dl (P < 0.05),生理指标得到了更好的控制,包括收缩压降低1.54 vs 7.12 mmHg (P = 0.003),体重降低2.48 kg vs 0.09 kg (P < 0.0001),体重指数为0.9 vs 0.05 (P < 0.0001)。结论:个性化、护士主导的CR显著提高了参与者对健康生活方式行为的依从性,降低了冠状动脉疾病患者的心脏危险因素。
Impact of nurse-led cardiac rehabilitation on patient's behavioral and physiological parameters after a coronary intervention: A pilot randomized controlled trial.
Background: Coronary artery disease, one of the leading causes of mortality and morbidity globally, is a major burden on healthcare resources. Cardiovascular rehabilitation is highly recommended for the early recovery of patients with Ischemic heart disease by improving the functional capacity and decreasing disease progression. A randomized controlled trial was conducted to assess the effect of nurse-led cardiac rehabilitation (CR) on behavioural parameters.
Materials and methods: Sixty-two adult patients who underwent percutaneous coronary intervention (PCI) were randomised to two groups to assess the effect of nurse-led cardiac rehabilitation (CR) on behavioural parameters, including adherence to drugs, cardiac diet, lifestyle changes, and selected physiological parameters. The intervention group had nurse-led individualized discharge counseling and clinical follow-up by telephone, whereas the control group received usual care. The comparisons between the control and intervention groups were made using independent Student's t-test or Mann-Whitney U test as appropriate. Pre-test and post-test scores were compared using paired t-test; all tests performed at 5% significance level.
Results: Participants in the intervention group presented with moderate to good smoking cessation, improved adherence to drugs (P < 0.0001), physically active lifestyle in 90.3 versus 45.2% (P < 0.0001), adherence to dietary changes, and improved healthcare satisfaction (P < 0.0001). There was also a significant reduction in triglycerides level in the intervention group at 62.51 versus 20.12 mg/dl in the control arm with (P < 0.05), and better controlled physiological indices, including a reduction in systolic blood pressure of 1.54 vs-7.12 mmHg (P = 0.003), bodyweight reduction of 2.48 kg versus-0.09 kg (P < 0.0001) and body mass index of 0.9 versus-0.05 (P < 0.0001).
Conclusion: Personalised, nurse-led CR significantly improved the participants adherence to healthy lifestyle behaviors and decreased the cardiac risk factors in patients with coronary artery disease.