Behaviour change techniques in home-based cardiac rehabilitation: a systematic review.
Behaviour change techniques in home-based cardiac rehabilitation: a systematic review.
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DOI：
10.3399/bjgp16x686617
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发表时间：
2016-10
期刊：
影响因子：
--
通讯作者：
Cupples ME
中科院分区：
文献类型：
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作者：
Heron N;Kee F;Donnelly M;Cardwell C;Tully MA;Cupples ME
提供心血管疾病（CVD）二级预防的心脏康复（CR）计划建议健康的生活方式行为，并推荐目标和规划、反馈和监测以及社会支持等行为改变技术（BCT）。需要更多有关 BCT 在家庭 CR 中使用的信息，以在实践中支持这些计划。确定并描述 BCT 在家庭 CR 项目中的使用。通过搜索 MEDLINE®、Embase、PsycINFO、Web of Science 和 Cochrane 数据库确定了 2005 年至 2015 年间的家庭 CR 随机对照试验。审稿人独立筛选标题和摘要的资格。包括 BCT 在内的相关数据是从纳入的研究中提取的。一项荟萃分析研究了家庭方案和比较方案中风险因素的变化。在已确定的 2448 项研究中，纳入了 11 项方法学质量良好的研究（10 项针对心肌梗死后，1 项针对心力衰竭，1907 名患者）。这些报告报告了 20 种不同 BCT 的使用情况。 10 项研究和目标设定（行为）均采用了社会支持（未具体说明）。在 11 项研究中，10 项报告了减少 CVD 危险因素的有效性，但一项研究显示与常规护理相比没有任何改善。这项研究与有效项目的不同之处在于，它不包括具有如何执行行为和监控说明的 BCT，也没有可靠的来源。社会支持和目标设定是家庭 CR 计划中经常使用的 BCT，其中 BCT 与监控、如何执行行为的指导以及有效计划中包含的可靠来源有关。需要进一步进行稳健的试验来确定 CR 项目中不同 BCT 的相对价值。
Cardiac rehabilitation (CR) programmes offering secondary prevention for cardiovascular disease (CVD) advise healthy lifestyle behaviours, with the behaviour change techniques (BCTs) of goals and planning, feedback and monitoring, and social support recommended. More information is needed about BCT use in home-based CR to support these programmes in practice. To identify and describe the use of BCTs in home-based CR programmes. Randomised controlled trials of home-based CR between 2005 and 2015 were identified by searching MEDLINE®, Embase, PsycINFO, Web of Science, and Cochrane Database. Reviewers independently screened titles and abstracts for eligibility. Relevant data, including BCTs, were extracted from included studies. A meta-analysis studied risk factor change in home-based and comparator programmes. From 2448 studies identified, 11 of good methodological quality (10 on post-myocardial infarction, one on heart failure, 1907 patients) were included. These reported the use of 20 different BCTs. Social support (unspecified) was used in all studies and goal setting (behaviour) in 10. Of the 11 studies, 10 reported effectiveness in reducing CVD risk factors, but one study showed no improvement compared to usual care. This study differed from effective programmes in that it didn’t include BCTs that had instructions on how to perform the behaviour and monitoring, or a credible source. Social support and goal setting were frequently used BCTs in home-based CR programmes, with the BCTs related to monitoring, instruction on how to perform the behaviour, and credible source being included in effective programmes. Further robust trials are needed to determine the relative value of different BCTs within CR programmes.