Representational Post-MI Nursing Intervention

描述（由申请人提供）：此R03申请寻求2年的支持，以开展方法开发和对心肌梗死（MI）患者康复护理干预的试点实施。干预的目标是改变患者对心肌梗死和冠心病（CHD）的常识模型（或认知表征）中的误解，最终目标是促进健康行为和提高生活质量。护理干预将使用半结构化的电话脚本来加强患者对冠心病的准确信念，同时通过应用社会心理学文献中关于说服的原则，创造有利于改变冠心病相关误解的条件。此外，干预措施将根据参与者的冠心病危险因素和他们对心肌梗死的独特认知表征进行定制。开发这种干预措施很重要，原因有两个。首先，对冠心病的误解在心肌梗死恢复期患者中非常普遍，这种误解预示着心肌梗死后患者对饮食、运动和戒烟建议的不遵守。其次，冠心病相关的误解在心肌梗死后妇女中尤为明显，这可能导致冠心病结局的性别差异。拟议的R03项目将解决3个具体目标：(1)开发护理干预的材料和程序；(2)采用单因素受试者间实验设计，对24例心肌梗死后患者进行干预试验；(3)评价干预措施大规模试验的可行性。试点研究将包括在出院后1周通过电话评估心肌梗死和冠心病的表现。治疗组在出院后2周接受电话干预，对照组接受标准治疗。8周后收集有关健康行为、症状和生活质量的结果数据。试点数据将用于完善协议并进行功率分析。

DESCRIPTION (provided by the applicant): This R03 application seeks 2 years of support to undertake the methodological development and pilot implementation of a nursing intervention for persons recovering from myocardial infarction (MI). The intervention will target the modification of misconceptions in patients' common sense models - or cognitive representations - of MI and coronary heart disease (CHD), with the ultimate goal of facilitating healthy behaviors and improving quality of life. The nursing intervention will use semi-structured telephone scripts to reinforce patients' accurate beliefs about CHD, while creating conditions conducive to the modification of CHD-related misconceptions through the application of principles from the social psychological literature on persuasion. In addition, the intervention will be tailored to participants' CHD risk factors and their unique cognitive representations of MI. The development of such an intervention is important for 2 reasons. First, misconceptions about CHD are very common among patients recovering from MI and such misconceptions predict non-adherence to post-MI recommendations regarding diet, exercise, and smoking cessation. Second, CHD-related misconceptions are especially pronounced among post-MI women and may contribute to gender disparities in CHD outcomes. The proposed R03 project will address 3 specific aims: (1) development of the materials and procedures for the nursing intervention; (2) pilot testing the intervention in a sample of 24 post-MI patients using a single-factor between-subjects experimental design; and (3) evaluating the feasibility of testing the intervention on a larger scale. The pilot study will involve assessing representations of MI and CHD by telephone at 1-week post-hospital discharge. Participants in the treatment group will receive the telephone intervention at 2 weeks post-discharge, with those in the control group receiving standard care. Outcome data regarding health behaviors, symptoms, and quality of life will be collected after 8-weeks. Pilot data will be used to refine the protocol and conduct a power analysis.