中国冠状动脉疾病门诊患者依从家庭心脏康复计划的预测因素

Cheng Ge, Jing Ma, Yong Xu, Yajun Shi, Chenghui Zhao, Ling Gao, Jing Bai, Yu Wang, Zhi-Jun Sun, Jun Guo, Yun-Dai Chen
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引用次数: 14

摘要

背景:心脏康复(CR)已被证明对冠状动脉疾病患者有益。然而,坚持CR计划是这些患者健康改善的关键。确定依从性的预测因素,这在中国是非常未知的,对于有效的康复是有价值的。本研究旨在确定中国冠状动脉疾病患者对家庭CR方案的依从性,并确定依从性的预测因素。方法选取2015年7月至2017年6月在北京解放军总医院第一医疗中心门诊就诊的冠心病患者1033例。参与者获得了运动处方,并参加了持续3-24个月的家庭运动训练。使用问卷来评估CR计划的完成情况、对计划的理解、患者的动机以及家人/同伴的支持。结果三分之二的患者对居家CR方案的依从性良好。老年患者(≥65岁)对该方案的依从性较好,而男性的依从性优于女性。有运动习惯(B = 6.756, P < 0.001)、了解运动计划(B = 0.078, P = 0.002)、参与动机较强(B = 0.376, P < 0.001)、家庭支持较好的患者(B = 0.487, P < 0.001)对运动计划的坚持程度也较好。结论:了解项目、患者自我激励和家庭支持有助于保持患者参与家庭CR项目。通过教育患者和家庭来改善家庭支持可能有助于提高对家庭CR计划的依从性。
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Predictors of adherence to home-based cardiac rehabilitation program among coronary artery disease outpatients in China
Background Cardiac rehabilitation (CR) has proven beneficial for patients with coronary artery disease. However, adherence to CR programs is the key to the health improvement in those patients. Identifying predictors for adherence, which is very much unknown in China, would be valuable for effective rehabilitation. This study aims to determine the adherence to home-based CR programs in Chinese coronary artery disease patients and determine predictors of adherence. Methods The current study included 1033 outpatients with coronary heart disease in the First Medical Center of Chinese PLA General Hospital in Beijing from July 2015 to June 2017. Participants were given an exercise prescription and took part in home-based exercise training lasting for 3–24 months. A questionnaire was used to evaluate the completion of the CR program, understanding of the program, motivation of the patients, and family/peer support. Results Two thirds of the patients adhered well to the home-based CR program. Elder patients (≥ 65-year-old) adhere to the program better, while men adhered better than women. Patients who used to exercise (B = 6.756, P < 0.001), understood the program (B = 0.078, P = 0.002), with stronger motivation to participate (B = 0.376, P < 0.001), and received better family support (B = 0.487, P < 0.001) also adhere better to the program. Conclusions Understanding the program, self-motivation of patients, and family support help to keep patients engaged in a home-based CR program. Improvement of family support by educating both patients and families may be helpful in improving adherence to home-based CR programs.
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