Effectiveness of a Tailored Lifestyle Management Program for Middle-Aged Women With Coronary Artery Disease: A Preliminary Study

Ching-Ching TSAI ； Ai-Hsien LI ； Chung-Ming TU ； Kai-Lin HWANG ； Chii JENG

《The Journal of Nursing Research》 27卷1期 (2019/02) Pp. 1-10-006

https://doi.org/10.1097/jnr.0000000000000271

摘要

Background: Coronary artery disease (CAD) is a leading cause of death in women. Many of the risk factors for CAD relate to lifestyle and thus may be influenced by lifestyle modification. However, middle-aged women often find it difficult to adjust their lifestyle behaviors. Thus, providing individualized treatment is crucial to reducing the risk and incidence of CAD in this population. Purpose: The aim of this study was to explore the effectiveness of a tailored lifestyle management program (TLMP) for middle-aged women with CAD. Methods: An experimental design was employed. Thirty-five middle-aged women with CAD (with stenosis [＞ 50%] of at least one main artery as determined by cardiac catheterization examination results) were recruited. The 35 women were randomly assigned to the experimental group (n = 17) or the control group (n = 18). Both groups received regular health education during their hospitalization. After discharge, the experimental group received the 12-week, home-based TLMP. A generalized estimating equation was used to examine the effects of the TLMP on metabolic and biomarker indicators for CAD. Results: The average age of participants was 56.1 ± 5.6 years. No significant demographic differences were identified between the two groups. Compared with the control group, the experimental group had a significantly higher high-density lipoprotein level (B = 7.83, p ＜ .001), a lower level of total cholesterol (B = -49.21, p = .04), and a lower waist circumference (B = -6.42, p ＜ .001). Conclusions/Implications for Practice: This study suggests that using tailored interventions is an effective approach to improving high-density lipoprotein, total cholesterol, and waist circumference in middle-aged women with CAD. This result is expected to have important implications for women’s healthcare, particularly in terms of preventing the incidence of CAD.

關鍵字

lifestyle management ； middle-aged women ； coronary artery disease

參考文獻

Hung, Y. Y., Hung, S. Y., Chou, C. L., & Chen, S. A. (2014). Cardiac rehabilitation among patients with acute myocardial infarction receiving percutaneous coronary intervention after acute myocardial infarction indicator was activated. Taiwan Journal of Physical Medicine and Rehabilitation, 42(3), 153-160. https://doi.org/10.6315/2014.42(3)03 (Original work published in Chinese)

Liu, D. H., Chen, Y. C., Hung, S. Y., & Chou, C. L. (2013). Cardiac rehabilitation after coronary artery bypass graft or heart valve replacement surgery-Experience of a medical center. Taiwan Journal of Physical Medicine and Rehabilitation, 41(3), 181-188. https://doi.org/10.6315/2013.41(3)04 (Original work published in Chinese).

Angus, J. E., King-Shier, K. M., Spaling, M. A., Duncan, A. S., Jaglal, S. B., Stone, J. A., & Clark, A. M. (2015). A secondary meta-synthesis of qualitative studies of gender and access to cardiac rehabilitation. Journal of Advanced Nursing, 71(8), 1758-1773. https://doi.org/10.1111/jan.12620

Artinian, N. T., Fletcher, G. F., Mozaffarian, D., Kris-Etherton, P., Van Horn, L., Lichtenstein, A. H., American Heart Association Prevention Committee of the Council on Cardiovascular Nursing. (2010). Interventions to promote physical activity and dietary lifestyle changes for cardiovascular risk factor reduction in adults: A scientific statement from the American Heart Association. Circulation, 122(4), 406-441. https://doi.org/10.1161/CIR.0b013e3181e8edf1

Beck, C., McSweeney, J. C., Richards, K. C., Roberson, P. K., Tsai, P. F., & Souder, E. (2010). Challenges in tailored intervention research. Nursing Outlook, 58(2), 104-110. http://dx.doi.org/10.1016/j.outlook.2009.10.004