A randomised controlled trial of senior Lay Health Mentoring in older people with ischaemic heart disease: The Braveheart Project
A randomised controlled trial of senior Lay Health Mentoring in older people with ischaemic heart disease: The Braveheart Project
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DOI：
10.1093/ageing/afh098
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发表时间：
2004-07-01
期刊：
影响因子：
6.7
通讯作者：
Hargreaves, AD
中科院分区：
文献类型：
--
作者：
Coull, AJ;Taylor, VH;Hargreaves, AD
目的：目的：研究使用经过培训的高级非专业健康导师对患有缺血性心脏病的老年人进行教育和赋权的效果和可行性。设计：盲法评价的随机对照试验。设置：法尔科克和地区皇家医院。参与者：60岁或以上的住院患者和门诊患者，诊断为心绞痛或急性心肌梗死，参加二级护理。319人进入，289人完成退出评估。干预组参加了为期1年的辅导组，每月开会2小时，每个由两个训练有素的外行健康导师除了标准care.Main结果的措施：主要结果的措施是冠状动脉危险因素的变化，药物的使用和实际使用的二级保健卫生服务。次要结果是总的和心血管事件;药物依从性的变化，非医疗支持需求，健康状况和心理功能，以及社会包容性。报告的当前运动评分有显著改善，（平均+0.33，+0.02至+0.52），每周平均步行时间增加72分钟（+1至+137分钟），SF 36身体功能评分（+6.1，+2.4至+9.5）。总脂肪减少1.0%（95% CI -3.0%至0.6%），饱和脂肪减少0.6%（95% CI -1.5%至0.03%）。干预组的冠心病门诊就诊率下降（-0.25次，-0.61至-0.08次）。出席率很高。社会经济分组并没有影响participation.Conclusions：奠定健康指导是可行的，实用的和包容性的，积极影响饮食，体育活动，和健康资源利用率在老年受试者缺血性心脏病，而不会造成伤害。
Objective: to examine the effects and feasibility of educating and empowering older people with ischaemic heart disease using trained senior lay health mentors.Design: randomised controlled trial with blinded evaluation.Setting: Falkirk and District Royal Infirmary.Participants: inpatients and outpatients aged 60 or over attending secondary care with a diagnosis of angina or acute myocardial infarction. Three-hundred and nineteen entered and 289 completed exit assessments. The intervention group took part in mentoring groups for 1 year, meeting monthly for 2 hours, each led by two trained lay health mentors in addition to standard care.Main outcome measures: primary outcome measures were changes in coronary risk factors, medication usage and actual use of secondary care health services. Secondary outcomes were total and cardiovascular events; changes in medication compliance, non-medical support requirement, health status and psychological functioning, and social inclusion.Results: there were significant improvements in a reported current exercise score (mean +0.33, +0.02 to +0.52), in the average time spent walking per week by 72 minutes (+1 to +137 minutes), and in the SF36 Physical Functioning Score (+6.1, +2.4 to +9.5). There was a 1.0% reduction in total fat (95% CI -3.0% to -0.6%) and a 0.6% reduction in saturated fat (95% CI -1.5% to -0.03%). The intervention group showed reduced outpatient attendance for coronary heart disease (-0.25 appointments, -0.61 to -0.08). Attendance rates were high. Socio-economic grouping did not affect participation.Conclusions: Lay Health Mentoring is feasible, practical and inclusive, positively influencing diet, physical activity, and health resource utilisation in older subjects with ischaemic heart disease without causing harm.