Representational Post-MI Nursing Intervention

描述(由申请人提供)：此R03申请寻求两年的支持，以承担方法的发展和试点实施的护理干预的人从心肌梗死(MI)康复者。这项干预将旨在纠正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电话脚本来强化患者对冠心病的准确信念，同时通过应用关于说服的社会心理学文献中的原则，创造有利于纠正与冠心病相关的误解的条件。此外，干预将根据参与者的冠心病风险因素和他们对心肌梗死的独特认知表现而量身定做。这种干预的发展之所以重要，有两个原因。首先，对冠心病的误解在心肌梗死恢复期患者中非常普遍，这种误解预示着不遵守心肌梗死后关于饮食、锻炼和戒烟的建议。其次，与冠心病相关的误解在心肌梗死后的女性中尤其明显，并可能导致冠心病结局中的性别差异。建议的R03项目将涉及三个具体目标：(1)制定护理干预的材料和程序；(2)采用单因素受试者间实验设计，在24名心肌梗死后患者样本中初步测试干预；以及(3)评估在更大范围内测试干预的可行性。试点研究将包括在出院后一周通过电话评估MI和CHD的陈述。治疗组患者在出院后2周接受电话干预，对照组患者接受标准护理。有关健康行为、症状和生活质量的结果数据将在8周后收集。试点数据将用于改进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.