A qualitative synthesis of factors influencing maintenance of lifestyle behaviour change in individuals with high cardiovascular risk
A qualitative synthesis of factors influencing maintenance of lifestyle behaviour change in individuals with high cardiovascular risk
复制标题
DOI：
10.1186/1471-2261-13-48
复制
发表时间：
2013-07-06
影响因子：
2.1
通讯作者：
House, Allan
中科院分区：
文献类型：
--
作者：
Murray, Jenni;Fenton, Grania;House, Allan
背景资料：心血管风险因素的管理包括患者承诺遵守处方药物并采取健康的生活方式。不幸的是，许多人未能采取和保持四个关键的健康行为（不吸烟，均衡饮食，限制酒精消费和更积极）。五个因素（信仰，知识，交通和其他费用，情感，朋友和家人的支持）是已知的预测吸收的生活方式行为的改变。影响维持健康生活方式的关键因素尚不清楚，但有助于支持为这一人群制定预防复发方案。我们的审查旨在澄清的主要患者认为的因素，影响维护改变健康的lifestyls.Methods：我们进行了系统的定性观察研究和应用的原则，内容合成和专题分析，提取报告的因素（障碍和促进者），个人认为是有影响力的改变健康的生活方式的行为。因素，然后组织成一个现有的框架，高阶类别，其次是因素之间的相互关系，以确定关键themes.Results：22项研究符合我们的纳入标准的分析。参与者报告了13类障碍和促进因素，其中大多数是促进因素。最常报告的影响是与社会支持（无论是正式还是非正式提供的）、信念（关于自身或健康状况不佳的原因和管理，以及保持生活方式行为的价值）和其他心理因素（包括态度、思维和应对方式，以及解决问题的技能）有关的影响。体育活动是四类中最常见的调查行为，但总体而言，主要障碍和促进因素与一系列行为有关。通过分析类别内的因素之间的相互关系，“社会支持”，“教育和知识”，和“信仰和情感”都被认为是关键themes.Conclusions：我们的审查表明，在大多数情况下，影响生活方式的改变的因素也很重要，保持健康的行为。这表明，在生活方式支助方案中解决这些障碍和促进因素也具有长期价值。
Background: Management of cardiovascular risk factors includes commitment from patients to adhere to prescribed medications and adopt healthy lifestyles. Unfortunately many fail to take up and maintain the four key healthy behaviours (not smoking, having a balanced diet, limiting alcohol consumption and being more active). Five factors (beliefs, knowledge, transport and other costs, emotions, and friends and family support) are known to predict uptake of lifestyle behaviour change. The key factors influencing maintenance of healthy lifestyles are not known but would be helpful to support the development of relapse prevention programmes for this population. Our review aimed to clarify the main patient perceived factors thought to influence maintenance of changed healthy lifestyles.Methods: We performed a systematic review of qualitative observational studies and applied the principles of content synthesis and thematic analysis to extract reported factors (barriers and facilitators) considered by individuals to be influential in maintaining changed healthy lifestyle behaviours. Factors were then organised into an existing framework of higher order categories which was followed by an analysis of the interrelationships between factors to identify key themes.Results: Twenty two studies met our inclusion criteria. Participants reported barriers and facilitators within 13 categories, the majority of which were facilitators. The most commonly reported influences were those relating to social support (whether provided formally or informally), beliefs (about the self or the causes and management of poor health, and the value of maintaining lifestyle behaviours), and other psychological factors (including attitude, thinking and coping styles, and problem solving skills). Physical activity was the most commonly investigated behaviour in four categories, but overall, the main barriers and facilitators were related to a range of behaviours. Through analysis of the interrelationships between factors within categories, 'social support', 'education and knowledge', and 'beliefs and emotions' were all considered key themes.Conclusions: Our review suggests that for the most part, factors that influence lifestyle change are also important for maintaining healthy behaviours. This indicates that addressing these barriers and facilitators within lifestyle support programmes would also be of value in the longer-term.