权益分类	功能权益	普通用户	{{item.name}}会员
{{category.name}}	{{benefitItem.name}}

RISK REDUCTION OF SEDENTARY BEHAVIOR POST CABG SURGERY

降低冠状动脉搭桥手术后久坐行为的风险

基本信息

批准号：
6071532
负责人：
NALINI N JAIRATH
金额：
$ 6.14万
依托单位：
UNIVERSITY OF MARYLAND BALTIMORE
依托单位国家：
美国
项目类别：
财政年份：
1997
资助国家：
美国
起止时间：
1997-08-01 至 2001-10-27
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/6071532
关键词：
clinical research coronary bypass exercise health services research tag human subject nursing models patient care management postoperative complications

项目摘要

DESCRIPTION (Adapted from the Investigator's Abstract): Sedentary behavior is a major risk factor for coronary artery disease (CAD) progression in coronary artery bypass graft (CABG) patients post-discharge. However, existing interventions primarily target patients ready to increase habitual exercise, fail to assist remaining patients progress to the point of physical and psychological readiness, and may have limited accessibility, and high attrition rates. Therefore, a multidimensional, community based, nurse directed intervention model to increase habitual exercise and reduce sedentary behavior is necessary. The specific aims of this pilot study are to (a) determine whether a trend exists supporting the Sedentary Behavior Intervention Model's (SBIM) effectiveness in decreasing sedentary behavior by promoting habitual exercise by CABG patients and (b) identify the magnitude of subjects attrition, reasons for, and distribution of, attrition among study groups (SBIM-experimental, standard care-control), gender and minorities. Should pilot data support the SBIM s effectiveness, a larger sample clinical trial will be conducted to confirm the SBIM's effectiveness. Data about subject attrition will be used to develop mechanisms to reduce attrition and modify the sampling scheme, as necessary, in the projected clinical trial. The SBIM is adapted from Prochaska and DiClemente's Trans-Theoretical Model which conceptualizes the process of behavioral change. In the SBIM, each patient receives a multi-dimensional set of interventions specifically adapted to his/her readiness to change sedentary behavior and increase habitual exercise. Readiness, expressed as a "stage of change," is determined by the patient s current behavior and intended behavior within the next 6 months. SBIM interventions focus upon (a) modifying patient perceptions of the relative benefits to drawbacks of increasing habitual exercise, (b) maximizing the effectiveness of strategies identified by the patient as helping promote exercise, and (c)minimizing barriers and maximizing factors facilitating habitual exercise. The 100 subjects will be stratified with respect to prestudy left ventricular function, gender, and minority status, and their "stage of change" determined. They will then be randomly assigned to receive either the SBIM (i.e. experimental) or the standard care (i.e. control) intervention for a 9 month period. Interventions will be delivered by a trained team of experienced cardiac nurses in our master's or doctoral nursing programs. A repeated measures experimental design will be used. Outcome variables include energy expenditure, functional capacity, cardiac exercise self-efficacy, and stage of change. Hypotheses/research questions are (a) experimental subject will exhibit significantly greater pre- to post-intervention increases in outcome variables than control subjects and (b) a significant amount of the variance in outcome variables will be accounted for the variables of group, cardiac rehabilitation program participation and prestudy left ventricular function, and (c) how is attrition distributed in the total sample and with respect to group, gender, and minority status.

描述（改编自研究者摘要）：久坐行为是冠状动脉疾病（CAD）进展的主要危险因素，冠状动脉旁路移植术（CABG）患者出院后。然而，在这方面，现有的干预措施主要针对准备增加习惯性运动，未能帮助其余患者进展到身体和心理上的准备，可能有有限的机会，和高损耗率。因此，一个多层面的，基于社区的，护士指导的干预模式，以增加习惯性运动，久坐行为是必要的。这项试验性研究的具体目的是（a）确定是否存在支持久坐行为的趋势干预模式（SBIM）减少久坐行为的有效性通过促进CABG患者的习惯性锻炼，以及（B）识别受试者流失的程度、流失的原因和分布在研究组（SBIM-实验组，标准护理-对照组）中，少数群体如果试点数据支持SBIM的有效性，将进行样本临床试验，以确认SBIM的有效性。关于受试者流失的数据将用于制定减少必要时，在预计的临床试验 SBIM改编自Prochaska和DiClemente的跨理论模型，概念化的行为过程变化在SBIM中，每个患者都接收一组多维的专门针对他/她改变久坐不动的准备情况的干预措施行为和增加习惯性锻炼。准备就绪，表示为“阶段由患者的当前行为决定，在接下来的6个月内。 SBIM的干预措施侧重于（a）改变患者对相对益处的感知，增加习惯性锻炼，（B）最大化策略的有效性被患者识别为有助于促进锻炼，以及（c）最小化障碍和最大化促进习惯性锻炼的因素。的100 受试者将根据研究前左心室职能、性别和少数地位及其“变化阶段” 测定然后，他们将被随机分配接受SBIM或 (i.e.实验）或标准护理（即对照）干预，月期间。干预措施将由一个训练有素的团队提供，在我们的硕士或博士护理课程经验丰富的心脏护士。一采用重复测量实验设计。结果变量包括能量消耗、功能能力、心脏锻炼自我效能和变化阶段。假设/研究问题是（a）实验对象将表现出明显更大的前干预后结果变量比对照组增加， (b)结果变量的显著差异将是占变量组，心脏康复计划参与和研究前左心室功能，以及（c）如何总样本中的损耗分布以及组，性别，少数民族地位。