Improving lifestyle and risk perception through patient involvement in nurse-led cardiovascular risk management: A cluster-randomized controlled trial in primary care
Improving lifestyle and risk perception through patient involvement in nurse-led cardiovascular risk management: A cluster-randomized controlled trial in primary care
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DOI：
10.1016/j.ypmed.2009.11.007
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发表时间：
2010-01-01
影响因子：
5.1
通讯作者：
Grol, Richard
中科院分区：
文献类型：
--
作者：
Koelewijn-van Loon, Marije S.;van der Weijden, Trudy;Grol, Richard
目标。目的：通过实习护士对患者进行心血管风险管理的干预，确定生活方式是否在短期内得到改善。黑斑羚研究(2006年，荷兰)是一项整群随机对照试验，涉及25个普通诊所和615名有资格进行心血管风险管理的患者。干预措施包括(1)个人10年心血管风险评估，(2)风险沟通，(3)决策辅助工具的使用和(4)由实习护士在两次会诊中应用的改编动机访谈。结果在基线和12周后测量的结果是吸烟、饮酒、饮食、体力活动和次要结果风险认知、焦虑、对决策的信心和对沟通的满意度。两组患者的生活方式均有不同程度的改善，但两组间差异无统计学意义。干预组患者在风险感知的适当性方面有所改善，尽管不显著。与对照组相比，干预组患者焦虑的适宜性明显提高，对沟通的满意度更高。干预似乎提高了患者的风险感知、焦虑和沟通满意度，这些都是共享决策的重要条件。然而，我们没有发现干预对生活方式的额外影响。(C)2009 Elsevier Inc.保留所有权利。
Objective. To determine if lifestyle improved at a short term through an intervention to involve patients in cardiovascular risk management by the practice nurse.Methods. The IMPALA study (2006, the Netherlands) was a cluster-randomised controlled trial involving 25 general practices and 615 patients who were eligible for cardiovascular risk management. The intervention consisted of (1) individual 10-year cardiovascular risk assessment, (2) risk communication, (3) use of a decision aid and (4) adapted motivational interviewing, applied by practice nurses in two consultations. Outcomes were smoking, alcohol, diet, physical activity and the secondary outcomes risk perception, anxiety, confidence about the decision and satisfaction with the communication, measured at baseline and after 12 weeks.Results. Patients of both groups improved their lifestyle, but no relevant significant differences between the groups were found. Intervention group patients improved in terms of the appropriateness of risk perception, although not significantly. Intervention group patients improved significantly in terms of appropriateness of anxiety and were more satisfied with the communication compared to control group patients.Conclusion. The intervention seems to have improved the patients' risk perception, anxiety and satisfaction with the communication, which are important conditions for shared decision making. However, we found no additional effect of the intervention on lifestyle. (C) 2009 Elsevier Inc. All rights reserved.