A nurse-led lifestyle intervention using mobile application versus booklet for adults with metabolic syndrome-Protocol for a randomized controlled trial

Nurse-led models of care for metabolic syndrome in primary care: A scoping review

AIM

To identify and map out existing nurse-led models of care for treatment and prevention of metabolic syndrome in primary care settings.

DESIGN

A scoping review.

METHODS

Conducted in accordance with the JBI methodology.

DATA SOURCES

A search of the databases PubMed, CINAHL Complete, Cochrane Library, Scopus, handsearch and a grey literature search was conducted in June 2022 and updated in March 2023.

RESULTS

Title and abstract screening was performed on 926 articles resulting in 40 articles for full text screening. Full text screening yielded seven articles that met inclusion criteria.

CONCLUSION

Additional research is needed on nursing models of care to prevent and treat metabolic syndrome. Future studies should concentrate on rigour with clearly defined objective inclusion criteria.

IMPLICATIONS TO CLINICAL PRACTICE

This review contributes a synthesis of the evidence on nurse-led models for metabolic syndrome in primary care.

IMPACT

This scoping review addresses metabolic syndrome, the precursor to non-communicable disease. The review mapped the evidence for nurse-led models of care for metabolic syndrome in the primary care setting. These findings promote the development and evaluation of novel nurse-led models of care which can mitigate the effect of the current epidemic.

REPORTING METHOD

PRISMA checklist for scoping reviews. No patient or public contribution was part of this study.

PROTOCOL REGISTRATION

Open Science Framework accessible at: https://osf.io/jfpw7/.

Impacts of Educational Interventions with Support of Mobile App versus Booklet for Patients with Hypertension and Metabolic Syndrome: A Secondary Data Analysis

BACKGROUND

Hypertension comorbid with metabolic syndrome could increase the development of adverse cardiovascular events. Educational interventions were effective to improve outcomes in patients.

METHODS

This was a secondary data analysis of participants with hypertension. The original randomized controlled trial aimed to examine the effect of app and booklet versus control among individuals diagnosed with metabolic syndrome living in the community. A 30-min health education was provided to each participant. In addition to the education, the app group received a mobile app while the booklet group received a booklet. Data were collected at baseline, week 4, week 12, and week 24. Intention-to-treat principle was followed, and generalized estimating equations was employed for data analysis.

RESULTS

A total of 118 participants with hypertension and metabolic syndrome were extracted from the three-arm trial data. The sample size was 36, 42, and 40 in the app group, booklet group, and control group, respectively. Compared to the control group, the app group showed a significant reduction on body weight and waist circumference at week 24, while the total exercise and self-efficacy for exercise were increased at week 12 and week 24 but no significant findings were observed in the booklet group.

CONCLUSIONS

The educational intervention supported with app was superior to the booklet support on the outcomes of body weight, waist circumference, total exercise, and self-efficacy for exercise among patients with hypertension and metabolic syndrome in the community.

Effectiveness of a Nurse-Led Support Programme Using a Mobile Application versus Phone Advice on Patients at Risk of Coronary Heart Disease – A Pilot Randomized Controlled Trial

Purpose

Coronary heart disease (CHD) is the leading cause of morbidity and mortality globally. This study aimed to examine the preliminary effect of a nurse-led support programme using a mobile application versus nursing telephone advice on patients at risk of CHD living in the community.

Patients and Methods

A prospective randomized controlled trial was adopted. Sixty eligible CHD participants were randomized into the app group (App) or the nursing telephone advice (NTA) group to support their own health care and exercise. Data were collected at baseline (T0), 1 month (T1), and 3 months (T2). Outcomes were total amount of exercise, self-efficacy of chronic disease management, total time of exercise, blood pressure, and lipid concentrations. Data were analyzed using the generalized estimating equation models.

Results

Ninety-two individuals were screened for eligibility and 60 were randomized into the app group (n = 30) or NTA group (n = 30). The mean age of the participants was 60.92. The total attrition rate at T2 was 1.66%. The app group showed a moderate effect (Cohen’s d =0.43) in significant increase in exercise amount, and reduction of lipid concentration (total cholesterol d=−0.43, triglyceride d=−0.39) respectively. Other outcomes showed improvement trend but non-significant between group.

Conclusion

The CHD app is effective to motivate CHD patients for maintaining exercise amount which will be beneficial to their lipid control.

Gender Differences of Health Behaviors in the Risk of Metabolic Syndrome for Middle-Aged Adults: A National Cross-Sectional Study in South Korea

This study examined gender differences in health behaviors for the risk of metabolic syndrome (MetS) among middle-aged adults using nationally representative data from the Seventh Korea National Health and Nutrition Examination Survey (2016–2018). The sample included data from 8677 middle-aged adults. The Health Practice Index measured health behaviors, including smoking, alcohol use, physical activity, sleeping, eating breakfast, working hours, nutritionally balanced diet, and mental stress. Complex sample multiple logistic regression analyses were conducted to determine the association between the Health Practice Index (HPI) and MetS. Men and women with poor or moderate HPI scores had significantly higher risks of having MetS than those with good HPI scores. Controlling for covariates, high-risk alcohol use (p < 0.001) and physical activity (p = 0.008) were associated with the risk of MetS in men and women, respectively. Men reporting alcohol use and women lacking a healthy diet were, respectively, 2.056 times (adjusted odds ratio (OR) = 2.056, 95% CI: 1.681–2.514) and 1.306 times (adjusted OR = 1.306, 95% CI: 1.075–1.587) more likely to have increased risks of MetS. Given these gender differences in health behaviors, developing tailored interventions could be beneficial in preventing MetS among middle-aged men and women.

The effects of a nurse-led lifestyle intervention program on cardiovascular risk, self-efficacy and health promoting behaviours among patients with metabolic syndrome: Randomized controlled trial

BACKGROUND

Metabolic syndrome is a cluster of cardio-metabolic risk factors and a major burden for public health due to its increasing prevalence and adverse effects on cardiovascular health. Lifestyle modification is the first-line intervention for metabolic syndrome management. However, adopting healthy behaviours is challenging among patients with metabolic syndrome.

OBJECTIVE

To examine the effects of a nurse-led lifestyle intervention program on cardiovascular risks, self-efficacy and the implementation of health promoting behaviours.

DESIGN

A two-armed randomized controlled trial.

SETTINGS AND PARTICIPANTS

A total of 173 patients that satisfied the metabolic syndrome definition of International Diabetes Federation was recruited from a hospital in North China.

METHODS

The participants were randomly assigned to either attend the lifestyle interventions (n = 86) or receive usual care from the study hospital (n = 87). The lifestyle intervention followed the framework of Health Promotion Model and consisted of one face-to-face education session (30-40 min), one educational booklet and six telephone follow-ups (bi-weekly, 20-30 min per call) in three months. The Framingham 10-year risk score was calculated to measure the participants' cardiovascular risks at baseline and 3-month. The Self-rated Abilities for Health Practices and Health Promoting Lifestyle Profile II was employed to measure the self-efficacy and health promoting behaviours at baseline, 1-month, and 3-month. The generalized estimating equation model was employed to examine the effects of the lifestyle intervention program.

RESULTS

No difference was detected in the baseline characteristics between the two groups. Decreased cardiovascular risk was found in the lifestyle intervention group, but no significant group-by-time effect was detected. The self-efficacy for nutrition, stress dimension and sum score of health promoting behaviours revealed significant improvements at 1-month (all p < 0.05). Significant improvements were also detected in all subscales, total scale of self-efficacy, all dimensions and the sum score of health promoting behaviours at 3-month (all p < 0.05).

CONCLUSIONS

The nurse-led Health Promotion Model guided lifestyle intervention program effectively improved the self-efficacy and implementation of health promoting behaviours in patients with metabolic syndrome. We recommend that nurses apply lifestyle interventions in routine care for patients with metabolic syndrome. Tweetable abstract: The RCT revealed that nurse-led lifestyle intervention was effective to improve self-efficacy and healthy behaviours among 173 MetS patients.