NURSING INTERVENTIONS TO REDUCE CORONARY RISK FACTORS

减少冠心病危险因素的护理干预措施

• 批准号: 2256837
• 负责人: Diane M. Becker
• 金额: $ 30.73万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 1991
• 资助国家: 美国
• 起止时间: 1991-02-01 至 1996-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2256837
• 关键词: antihypertensive agents; behavior modification; blood lipid; blood pressure; body physical activity; body weight; cardiovascular disorder chemotherapy; cardiovascular disorder diagnosis; cardiovascular disorder education; chemoprevention; cholesterol; clinical trials; coronary disorder; diet; dietary sodium; disease /disorder proneness /risk; exercise; goal oriented behavior; health behavior; human middle age (35-64); human subject; human therapy evaluation; hypertension; hypertriglyceridemia; lifestyle; longitudinal human study; noninsulin dependent diabetes mellitus; nurse practitioners; nursing care evaluation; nursing intervention; nutrition related tag; problem solving; questionnaires; siblings; smoking cessation; social support network; statistics /biometry; therapy compliance; triglycerides

This study represents a trial of a nursing intervention versus "usual" care administered through the primary provider system with the major goal of lowering cardiovascular risk factors in asymptomatic siblings of people with premature coronary disease. The nursing intervention is based on a problem-solving framework which directs behavior change through repeated problem-solving tasks in a clinical setting. The study is designed as a randomized trial of nurse-mediated interventions for hyperlipidemia, hypertension and cigarette smoking which are based on standardized medical treatment placed in the context of an adherence-oriented problem-solving set of encounters with a nurse practitioner. Following an extensive risk factor screening of 550 asymptomatic siblings of index cases hospitalized for coronary disease, the approximately 350 resulting eligible siblings with risk factors will be randomly assigned to the nursing intervention group or a usual care group and followed for outcome evaluation at 1 and 2 years. The major outcomes will be achievement of nationally recognized goal levels of cholesterol and blood pressure, and smoking cessation. Statistical analysis will focus on the proportion in each group who achieve these goals at the follow-up periods. In addition, multiple logistic regression analysis will be performed to determine the best set of predictors of risk factor goal attainment in the overall group. Specific elements of the social-problem solving framework will be examined within the nursing intervention group to determine their impact on two related health behaviors, compliance with a Step One Diet and compliance with an exercise prescription. This study is significant because of the lack of prior intervention studies specifically in high risk families who represent the major burden of premature coronary disease in the U.S.

这项研究代表了护理干预与“常规”护理的试验 通过主要提供商系统管理的主要目标 无症状的兄弟姐妹中降低心血管危险因素 患有过早的冠状动脉疾病。 护理干预是基于 解决问题的框架，通过重复指导行为改变 在临床环境中解决问题的任务。 该研究被设计为 护士介导的高脂血症干预措施的随机试验， 基于标准化医疗的高血压和吸烟 在依从性解决问题的背景下进行的处理 与护士从业人员的相遇。 遵循广泛的风险 索引病例的550个无症状兄弟姐妹的因子筛查住院 对于冠状动脉疾病，大约有350个符合条件的兄弟姐妹 随着风险因素将随机分配给护理干预 小组或通常的护理小组，然后在1和2处进行结果评估 年。 主要结果将是获得全国认可的 胆固醇和血压的目标水平以及戒烟。 统计分析将重点放在每个实现的组中的比例 这些目标在后续时期。 另外，多个逻辑 将进行回归分析以确定最佳集合 整个组的风险因素目标达到的预测因素。 具体的 社交问题解决框架的要素将在其中检查 护理干预小组确定其对两个相关的影响 健康行为，遵守第一步的饮食，并符合 运动处方。 这项研究很重要，因为缺乏 先前的干预研究专门针对代表的高风险家庭 美国过早冠状动脉疾病的主要负担