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Izadi-Avanji FS, Mousavi TS, Sabery M. Translate and psychometric evaluation of the scale of knowledge of cardiovascular risk factors and lifestyle after coronary event. BMC Cardiovasc Disord 2025; 25:391. [PMID: 40399784 PMCID: PMC12096684 DOI: 10.1186/s12872-025-04819-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2025] [Accepted: 05/02/2025] [Indexed: 05/23/2025] Open
Abstract
BACKGROUND Coronary heart disease (CHD) is a leading cause of morbidity and mortality worldwide. The level of self-care after coronary events is closely linked to understanding cardiovascular risk factors and adopting healthier lifestyle behaviors. An appropriate scale can help healthcare providers measure patients' understanding of cardiovascular risk factors and provide educational interventions. This study aimed to translate and conduct a psychometric evaluation of the scale of knowledge of cardiovascular risk factors and lifestyle after coronary events. METHODS A standardized guideline was followed for translating and culturally adapting the English version of the Scale of Knowledge of Cardiovascular Risk Factors and Lifestyle after Coronary Events. The study included 300 patients with CHD aged 23 to 90. Exploratory factor analysis (EFA) was used to analyze construct validity. Internal consistency was estimated with Cronbach's alpha (0.98), and the intra-class correlation coefficient (ICC) was used to assess scale stability (0.84). RESULTS A total of 300 patients with an average age of 56.6 ± 12.7 were evaluated. Exploratory factor analysis confirmed construct validity, resulting in a 4-factor model comprising knowledge of cardiovascular risks (7 items), knowledge of lifestyle recommendations (6 items), knowledge of cholesterol and blood pressure control (5 items), and knowledge of diabetes (3 items). Together, these factors explained 67.34% of the total variance. The Cronbach's alpha for internal consistency of the scale was 0.851. Additionally, scale stability, as measured by the test-retest method, was 0.84, which is acceptable according to the minimum value of 0.70. CONCLUSION The translated Scale of Knowledge of Cardiovascular Risk Factors and Lifestyle after Coronary Events demonstrated strong psychometric properties among patients with CHD. The scale is both reliable and valid, providing healthcare providers with a practical tool to evaluate patient understanding and guide educational efforts aimed at enhancing post-coronary event self-care. CLINICAL TRIAL NUMBER Not applicable.
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Affiliation(s)
| | | | - Mahdieh Sabery
- Trauma Nursing Research Center,Kashan University of Medical Sciences, Kashan, Iran
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2
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Bulto LN, Hendriks JM. Navigating the complexities of addressing alcohol use in cardiology services. Eur J Cardiovasc Nurs 2024; 23:e113-e114. [PMID: 38593223 DOI: 10.1093/eurjcn/zvae045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Accepted: 03/27/2024] [Indexed: 04/11/2024]
Affiliation(s)
- Lemma N Bulto
- College of Nursing and Health Sciences, Caring Futures Institute, Flinders University, Sturt Rd, Bedford Park, SA 5042, Australia
| | - Jeroen M Hendriks
- College of Nursing and Health Sciences, Caring Futures Institute, Flinders University, Sturt Rd, Bedford Park, SA 5042, Australia
- Centre for Heart Rhythm Disorders, University of Adelaide and Royal Adelaide Hospital, Adelaide, SA 5001, Australia
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Lorenc T, Stokes G, Fulbright H, Sutcliffe K, Sowden A. Communicating cardiovascular risk: Systematic review of qualitative evidence. PATIENT EDUCATION AND COUNSELING 2024; 123:108231. [PMID: 38471312 DOI: 10.1016/j.pec.2024.108231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 02/19/2024] [Accepted: 02/26/2024] [Indexed: 03/14/2024]
Abstract
INTRODUCTION Cardiovascular risk prediction models are widely used to help individuals understand risk and make decisions. METHODS Systematic review of qualitative evidence. We searched MEDLINE, Embase, PsycINFO and CINAHL. We included English-language qualitative studies on the communication of cardiovascular risk. We assessed study quality using Hawker et al.'s tool and synthesised data thematically. RESULTS Thirty-seven studies were included. Many patients think that risk scores are of limited practical value. Other sources of information feed into informal estimates of risk, which may lead patients to reject the results of clinical risk assessment when the two conflict. Clinicians identify a number of barriers to risk communication, including patients' limited understanding of risk and excessive anxiety. They use a range of strategies for adapting risk communication. Both clinicians and individuals express specific preferences for risk communication formats. DISCUSSION Ways of communicating risk that provide some comparison or reference point seem more promising. The broader context of communication around risk may be more important than the risk scoring instrument. Risk communication interventions, in practice, may be more about appeals to emotion than a rationalistic model of decision-making.
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Affiliation(s)
- Theo Lorenc
- Centre for Reviews and Dissemination, University of York, York YO10 5DD, UK.
| | - Gillian Stokes
- EPPI-Centre, Social Science Research Unit, University College London, Gower Street, London WC1E 6BT, UK
| | - Helen Fulbright
- Centre for Reviews and Dissemination, University of York, York YO10 5DD, UK
| | - Katy Sutcliffe
- EPPI-Centre, Social Science Research Unit, University College London, Gower Street, London WC1E 6BT, UK
| | - Amanda Sowden
- Centre for Reviews and Dissemination, University of York, York YO10 5DD, UK
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4
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Fujiyoshi A, Kohsaka S, Hata J, Hara M, Kai H, Masuda D, Miyamatsu N, Nishio Y, Ogura M, Sata M, Sekiguchi K, Takeya Y, Tamura K, Wakatsuki A, Yoshida H, Fujioka Y, Fukazawa R, Hamada O, Higashiyama A, Kabayama M, Kanaoka K, Kawaguchi K, Kosaka S, Kunimura A, Miyazaki A, Nii M, Sawano M, Terauchi M, Yagi S, Akasaka T, Minamino T, Miura K, Node K. JCS 2023 Guideline on the Primary Prevention of Coronary Artery Disease. Circ J 2024; 88:763-842. [PMID: 38479862 DOI: 10.1253/circj.cj-23-0285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Affiliation(s)
| | - Shun Kohsaka
- Department of Cardiology, Keio University School of Medicine
| | - Jun Hata
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University
| | - Mitsuhiko Hara
- Department of Health and Nutrition, Wayo Women's University
| | - Hisashi Kai
- Department of Cardiology, Kurume Univeristy Medical Center
| | | | - Naomi Miyamatsu
- Department of Clinical Nursing, Shiga University of Medical Science
| | - Yoshihiko Nishio
- Department of Diabetes and Endocrine Medicine, Kagoshima University Graduate School of Medical and Dental Sciences
| | - Masatsune Ogura
- Department of General Medical Science, Chiba University School of Medicine
- Department of Metabolism and Endocrinology, Eastern Chiba Medical Center
| | - Masataka Sata
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | | | - Yasushi Takeya
- Division of Helath Science, Osaka University Gradiate School of Medicine
| | - Kouichi Tamura
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine
| | | | - Hiroshi Yoshida
- Department of Laboratory Medicine, The Jikei University Kashiwa Hospital
| | - Yoshio Fujioka
- Division of Clinical Nutrition, Faculty of Nutrition, Kobe Gakuin University
| | | | - Osamu Hamada
- Department of General Internal Medicine, Takatsuki General Hospital
| | | | - Mai Kabayama
- Division of Health Sciences, Osaka University Graduate School of Medicine
| | - Koshiro Kanaoka
- Department of Medical and Health Information Management, National Cerebral and Cardiovascular Center
| | - Kenjiro Kawaguchi
- Division of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University
| | | | | | | | - Masaki Nii
- Department of Cardiology, Shizuoka Children's Hospital
| | - Mitsuaki Sawano
- Department of Cardiology, Keio University School of Medicine
- Yale New Haven Hospital Center for Outcomes Research and Evaluation
| | | | - Shusuke Yagi
- Department of Cardiovascular Medicine, Tokushima University Hospital
| | - Takashi Akasaka
- Department of Cardiovascular Medicine, Nishinomiya Watanabe Cardiovascular Cerebral Center
| | - Tohru Minamino
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Meidicine
| | - Katsuyuki Miura
- Department of Preventive Medicine, NCD Epidemiology Research Center, Shiga University of Medical Science
| | - Koichi Node
- Department of Cardiovascular Medicine, Saga University
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Bernal-Jiménez MÁ, Calle G, Gutiérrez Barrios A, Gheorghe LL, Cruz-Cobo C, Trujillo-Garrido N, Rodríguez-Martín A, Tur JA, Vázquez-García R, Santi-Cano MJ. Effectiveness of an Interactive mHealth App (EVITE) in Improving Lifestyle After a Coronary Event: Randomized Controlled Trial. JMIR Mhealth Uhealth 2024; 12:e48756. [PMID: 38648103 PMCID: PMC11074898 DOI: 10.2196/48756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 10/27/2023] [Accepted: 01/17/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Coronary heart disease is one of the leading causes of mortality worldwide. Secondary prevention is essential, as it reduces the risk of further coronary events. Mobile health (mHealth) technology could become a useful tool to improve lifestyles. OBJECTIVE This study aimed to evaluate the effect of an mHealth intervention on people with coronary heart disease who received percutaneous coronary intervention. Improvements in lifestyle regarding diet, physical activity, and smoking; level of knowledge of a healthy lifestyle and the control of cardiovascular risk factors (CVRFs); and therapeutic adherence and quality of life were analyzed. METHODS This was a randomized controlled trial with a parallel group design assigned 1:1 to either an intervention involving a smartphone app (mHealth group) or to standard health care (control group). The app was used for setting aims, the self-monitoring of lifestyle and CVRFs using measurements and records, educating people with access to information on their screens about healthy lifestyles and adhering to treatment, and giving motivation through feedback about achievements and aspects to improve. Both groups were assessed after 9 months. The primary outcome variables were adherence to the Mediterranean diet, frequency of food consumed, patient-reported physical activity, smoking, knowledge of healthy lifestyles and the control of CVRFs, adherence to treatment, quality of life, well-being, and satisfaction. RESULTS The study analyzed 128 patients, 67 in the mHealth group and 61 in the control group; most were male (92/128, 71.9%), with a mean age of 59.49 (SD 8.97) years. Significant improvements were observed in the mHealth group compared with the control group regarding adherence to the Mediterranean diet (mean 11.83, SD 1.74 points vs mean 10.14, SD 2.02 points; P<.001), frequency of food consumption, patient-reported physical activity (mean 619.14, SD 318.21 min/week vs mean 471.70, SD 261.43 min/week; P=.007), giving up smoking (25/67, 75% vs 11/61, 42%; P=.01), level of knowledge of healthy lifestyles and the control of CVRFs (mean 118.70, SD 2.65 points vs mean 111.25, SD 9.05 points; P<.001), and the physical component of the quality of life 12-item Short Form survey (SF-12; mean 45.80, SD 10.79 points vs mean 41.40, SD 10.78 points; P=.02). Overall satisfaction was higher in the mHealth group (mean 48.22, SD 3.89 vs mean 46.00, SD 4.82 points; P=.002) and app satisfaction and usability were high (mean 44.38, SD 6.18 out of 50 points and mean 95.22, SD 7.37 out of 100). CONCLUSIONS The EVITE app was effective in improving the lifestyle of patients in terms of adherence to the Mediterranean diet, frequency of healthy food consumption, physical activity, giving up smoking, knowledge of healthy lifestyles and controlling CVRFs, quality of life, and overall satisfaction. The app satisfaction and usability were excellent. TRIAL REGISTRATION Clinicaltrials.gov NCT04118504; https://clinicaltrials.gov/study/NCT04118504.
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Affiliation(s)
- María Ángeles Bernal-Jiménez
- Faculty of Nursing and Physiotherapy, University of Cádiz, Cádiz, Spain
- Institute of Biomedical Research and Innovation of Cádiz, Cádiz, Spain
- Research Group on Nutrition: Molecular, Pathophysiological and Social Issues, University of Cádiz, Cádiz, Spain
| | - German Calle
- Institute of Biomedical Research and Innovation of Cádiz, Cádiz, Spain
- Cardiology Unit, Puerta del Mar Hospital, Cádiz, Spain
| | - Alejandro Gutiérrez Barrios
- Institute of Biomedical Research and Innovation of Cádiz, Cádiz, Spain
- Cardiology Unit, Puerta del Mar Hospital, Cádiz, Spain
| | - Livia Luciana Gheorghe
- Institute of Biomedical Research and Innovation of Cádiz, Cádiz, Spain
- Cardiology Unit, Puerta del Mar Hospital, Cádiz, Spain
| | - Celia Cruz-Cobo
- Faculty of Nursing and Physiotherapy, University of Cádiz, Cádiz, Spain
- Institute of Biomedical Research and Innovation of Cádiz, Cádiz, Spain
- Research Group on Nutrition: Molecular, Pathophysiological and Social Issues, University of Cádiz, Cádiz, Spain
| | - Nuria Trujillo-Garrido
- Faculty of Nursing and Physiotherapy, University of Cádiz, Cádiz, Spain
- Institute of Biomedical Research and Innovation of Cádiz, Cádiz, Spain
- Research Group on Nutrition: Molecular, Pathophysiological and Social Issues, University of Cádiz, Cádiz, Spain
| | - Amelia Rodríguez-Martín
- Faculty of Nursing and Physiotherapy, University of Cádiz, Cádiz, Spain
- Biomedicine, Biotechnology and Public Health Department, University of Cádiz, Cádiz, Spain
| | - Josep A Tur
- Research Group on Community Nutrition & Oxidative Stress, University of the Balearic Islands, Palma de Mallorca, Spain
- Network Biomedical Research Center "Pathophysiology of Obesity and Nutrition", Carlos III Health Institute, Madrid, Spain
| | - Rafael Vázquez-García
- Institute of Biomedical Research and Innovation of Cádiz, Cádiz, Spain
- Cardiology Unit, Puerta del Mar Hospital, Cádiz, Spain
| | - María José Santi-Cano
- Faculty of Nursing and Physiotherapy, University of Cádiz, Cádiz, Spain
- Institute of Biomedical Research and Innovation of Cádiz, Cádiz, Spain
- Research Group on Nutrition: Molecular, Pathophysiological and Social Issues, University of Cádiz, Cádiz, Spain
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Komaç F, Duru P. The effect of education based on a health belief model and motivational interviews on cardiovascular disease risk factors and healthy lifestyle behaviour changes in patients with essential hypertension: A randomized controlled trial. PATIENT EDUCATION AND COUNSELING 2024; 120:108126. [PMID: 38154390 DOI: 10.1016/j.pec.2023.108126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 12/16/2023] [Accepted: 12/20/2023] [Indexed: 12/30/2023]
Abstract
OBJECTIVE To determine the effects of "Health Belief Model (HBM)-based education" and "education and motivational interviews (MIs)" by comparing the two methods on cardiovascular disease (CVD) risk factors and healthy lifestyle behaviour changes of patients diagnosed with essential hypertension. METHODS The study was a single-centre, single-blind, parallel-group, 6-month follow-up, randomized controlled trial. It was conducted on 80 individuals (40 in the study group, 40 in the control group). Both groups received HBM-based education and an educational booklet on healthy lifestyle behaviour changes at the beginning of the study. Additionally, the study group underwent a total of 6 MIs. RESULTS The decrease in the study group's 10-year Framingham CVD risk scores (mean difference 5,33) compared to the baseline values was higher than that observed in the control group (mean difference 3,95). Over the six-month follow-up period, the study group's knowledge of CVD risk factors increased, and healthy lifestyle behaviour improved. CONCLUSION HBM-based education and an educational booklet, either alone or in combination with MI, supported patients with essential hypertension in lowering their CVD risk through lifestyle modifications. PRACTICE IMPLICATIONS Healthcare professionals within primary healthcare settings can use HBM-based health education and short-term MIs to reduce CVD risk and improve health outcomes.
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Affiliation(s)
- Firdes Komaç
- Department of Nursing, Institute of Health Sciences, Eskisehir Osmangazi University & Isıklar Family Health Centre, Eskisehir, Türkiye
| | - Pınar Duru
- Department of Public Health Nursing, Faculty of Health Sciences, Eskisehir Osmangazi University, Eskisehir, Türkiye.
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Xu L, Pinxten W, Vandereyt F, Falter M, Scherrenberg M, Kizilkilic SE, Van Erum H, Dendale P, Kindermans H. Motivational communication skills to improve motivation and adherence in cardiovascular disease prevention: A narrative review. Clin Cardiol 2023; 46:1474-1480. [PMID: 37675783 PMCID: PMC10716351 DOI: 10.1002/clc.24128] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 07/27/2023] [Accepted: 08/08/2023] [Indexed: 09/08/2023] Open
Abstract
Lifestyle optimization is one of the most essential components of cardiovascular disease prevention. Motivational counseling provided by health care professionals could promote lifestyle modification. The purpose of the review is to identify possible evidence-based psychological principles that may be applicable to motivational counseling in the prevention of cardiovascular disease. These motivational communication skills promote behavioral change, improved motivation and adherence to cardiovascular disease prevention. A personal collection of the relevant publications. The review identified and summarized the previous evidence of implementation intentions, mental contrasting, placebo effect and nocebo effects and identity-based regulations in behavior change interventions and proposed their potential application in cardiovascular disease prevention. However, it is challenging to provide real support in sustainable CVD-risk reduction and encourage patients to implement lifestyle changes, while avoiding being unnecessarily judgmental, disrespectful of autonomy, or engaging patients in burdensome efforts that have little or no effect on the long run. Motivational communication skills have a great potential for effectuating sustainable lifestyle changes that reduce CVD-related risks, but it is also surrounded by ethical issues that should be appropriately addressed in practice. It is key to realize that motivational communication is nothing like an algorithm that is likely to bring about sustainable lifestyle change, but a battery of interventions that requires specific expertise and long term joint efforts of patients and their team of caregivers.
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Affiliation(s)
- Linqi Xu
- UHasseltFaculty of Medicine and Life SciencesDiepenbeekBelgium
- Heart Centre HasseltJessa HospitalHasseltBelgium
- School of NursingJilin UniversityChangchunChina
| | - Wim Pinxten
- UHasseltFaculty of Medicine and Life SciencesDiepenbeekBelgium
| | | | - Maarten Falter
- UHasseltFaculty of Medicine and Life SciencesDiepenbeekBelgium
- Heart Centre HasseltJessa HospitalHasseltBelgium
- Department of Cardiology, KULeuvenFaculty of MedicineLeuvenBelgium
| | - Martijn Scherrenberg
- UHasseltFaculty of Medicine and Life SciencesDiepenbeekBelgium
- Heart Centre HasseltJessa HospitalHasseltBelgium
- Faculty of Medicine and Health SciencesAntwerp UniversityAntwerpBelgium
| | - Sevda Ece Kizilkilic
- UHasseltFaculty of Medicine and Life SciencesDiepenbeekBelgium
- Heart Centre HasseltJessa HospitalHasseltBelgium
| | - Hanne Van Erum
- UHasseltFaculty of Medicine and Life SciencesDiepenbeekBelgium
| | - Paul Dendale
- UHasseltFaculty of Medicine and Life SciencesDiepenbeekBelgium
- Heart Centre HasseltJessa HospitalHasseltBelgium
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Alenius S, Olsson K, Thomasson E, Magnusson L. Health care professionals' experiences and perceptions of health promotion through the health dialogue intervention in the scania region, Sweden: a qualitative interview study. BMC PRIMARY CARE 2023; 24:173. [PMID: 37661252 PMCID: PMC10476376 DOI: 10.1186/s12875-023-02133-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 08/21/2023] [Indexed: 09/05/2023]
Abstract
BACKGROUND Cardiovascular disease and type 2 diabetes are among the largest public health challenges in Sweden. Research indicates that a healthy lifestyle can prevent most cases. The health dialogue is an evidence-based public health programme for primary care with positive results in several regions of Sweden. This study aimed to describe health care professionals' experiences and perceptions of health promotion through the health dialogue intervention during the pilot phase in the Scania region of Sweden. METHODS The study consists of 12 individual interviews with health care professionals educated in the health dialogue method, implementing the intervention in Scania. Qualitative content analysis with an inductive approach was used. RESULTS The analysis resulted in 10 sub-categories and the four main categories: A more health-promoting mindset would benefit primary care; Empower individuals; Facilitate sustainable lifestyle changes; Challenges, tools and support for the implementation of the health dialogue. One overarching theme emerged: "Health dialogue, a potential start of a paradigm shift in Swedish primary care". CONCLUSIONS Conclusions imply that the health dialogue is a well-structured method with tools to make health promotion and primary prevention an integrated part of primary care. A respectful and motivating approach during the health dialogue is recommended. It is important to have an ongoing discussion about the approach among the health care professionals. Incorporating the Health Belief Model in the health care professionals' education in the method could increase the focus on self-efficacy during counselling, which could favour the participants' change process.
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Affiliation(s)
- Sara Alenius
- Department of Health Sciences, Faculty of Medicine, Lund University, Box 157, Lund, 221 00, Sweden
| | - Kjell Olsson
- Nutritional Epidemiology, Department of Clinical Sciences Malmö, Lund University, Malmö, SE-21428, Sweden
- Department of Healthcare Management, Region Skåne, Kristianstad, 291 89, Sweden
| | - Ena Thomasson
- Department of Healthcare Management, Region Skåne, Kristianstad, 291 89, Sweden
| | - Lina Magnusson
- Department of Health Sciences, Faculty of Medicine, Lund University, Box 157, Lund, 221 00, Sweden.
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Shea S, Lionis C, Kite C, Atkinson L, Lagojda L, Chaggar SS, Kyrou I, Randeva HS. Challenges in the Management of Non-Alcoholic Fatty Liver Disease (NAFLD): Towards a Compassionate Approach. LIVERS 2023; 3:434-447. [DOI: 10.3390/livers3030031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2025] Open
Abstract
Representing a growing ‘silent epidemic’, non-alcoholic fatty liver disease (NAFLD) affects around 25–30% of the general population. Alarmingly, NAFLD increases the risk of cardiovascular disease, both independently and through its strong associations with obesity, type 2 diabetes, and metabolic syndrome, whilst posing a substantial burden from an economic and health-related quality of life perspective. Moreover, growing evidence links NAFLD to common mental health disorders including depression, anxiety, and stress. In this context, recent clinical and research attention further focuses on potential additional problems faced by patients with NAFLD, such as perceived stigma, lack of awareness regarding the condition, and possible feelings of loneliness and isolation that might emerge from unmet support needs. To date, despite a wealth of literature on NAFLD, management of the condition remains challenging and not straightforward, with most cases in primary care being treated with lifestyle modification on top of any other comorbidity treatment. However, for many patients with NAFLD, weight loss is hard to accomplish and/or sustain (e.g., patients may lack the skills, confidence, and motivation required to adhere to dietary changes, and/or may have problems limiting opportunities for increased physical activity). Therefore, tailored interventions which are manageable from the perspective of the individual patient with NAFLD could glean greater results. Accordingly, although there is a lack of research exploring the potential benefits of person-centered and compassion-based approaches to the management of NAFLD, in the present review, we draw on evidence from methods utilized in the treatment of other chronic conditions in postulating the view that such approaches might prove beneficial in the future management of NAFLD.
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Affiliation(s)
- Sue Shea
- Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism (WISDEM), University Hospitals Coventry and Warwickshire NHS Trust, Coventry CV2 2DX, UK
| | - Christos Lionis
- Laboratory of “Health and Science”, School of Medicine, University of Crete, 71003 Heraklion, Greece
- Department of Health, Medicine and Caring Sciences, University of Linkoping, SE-58183 Linkoping, Sweden
- Department of Nursing, Frederick University, 1036 Nicosia, Cyprus
| | - Chris Kite
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism (WISDEM), University Hospitals Coventry and Warwickshire NHS Trust, Coventry CV2 2DX, UK
- School of Health and Society, Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton WV1 1LY, UK
- Centre for Sport, Exercise and Life Sciences, Research Institute for Health & Wellbeing, Coventry University, Coventry CV1 5FB, UK
- Chester Medical School, University of Chester, Shrewsbury SY3 8HQ, UK
| | - Lou Atkinson
- Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism (WISDEM), University Hospitals Coventry and Warwickshire NHS Trust, Coventry CV2 2DX, UK
- EXI, People’s Mission Hall, 20-30 Whitechapel Road, London E1 1EW, UK
| | - Lukasz Lagojda
- Clinical Evidence Based Information Service (CEBIS), University Hospitals Coventry and Warwickshire NHS Trust, Coventry CV2 2DX, UK
| | | | - Ioannis Kyrou
- Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism (WISDEM), University Hospitals Coventry and Warwickshire NHS Trust, Coventry CV2 2DX, UK
- Centre for Sport, Exercise and Life Sciences, Research Institute for Health & Wellbeing, Coventry University, Coventry CV1 5FB, UK
- Aston Medical School, College of Health and Life Sciences, Aston University, Birmingham B4 7ET, UK
- Laboratory of Dietetics and Quality of Life, Department of Food Science and Human Nutrition, School of Food and Nutritional Sciences, Agricultural University of Athens, 11855 Athens, Greece
| | - Harpal S. Randeva
- Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism (WISDEM), University Hospitals Coventry and Warwickshire NHS Trust, Coventry CV2 2DX, UK
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Moscatelli F, De Maria A, Marinaccio LA, Monda V, Messina A, Monacis D, Toto G, Limone P, Monda M, Messina G, Monda A, Polito R. Assessment of Lifestyle, Eating Habits and the Effect of Nutritional Education among Undergraduate Students in Southern Italy. Nutrients 2023; 15:2894. [PMID: 37447220 DOI: 10.3390/nu15132894] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 06/22/2023] [Accepted: 06/25/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND The years spent at university represent a critical period that can influence both the quality of lifestyle and the eating habits of subsequent adulthood, and also, in the long term, the health of the individual. The aim of this study was to investigate the lifestyle of university students living away from home. METHODS Each subject recruited for the study was given a questionnaire to obtain general information, eating habits and physical activity levels before (T0) and after six month of training seminars (T1). Blood pressure, body composition and questionnaire responses were investigated. RESULTS The main findings of this study are a significant decrement in blood pressure; an increment in physical activity practice; an increased number of subjects who pay attention to the calorific value of food and also an improvement in BIA parameters. CONCLUSIONS In conclusion, this study demonstrated the challenges that university students face in leading a healthy lifestyle and caring for their nutritional needs, particularly when they are away from their families. No intervention specifically targets young adults, even though much emphasis is placed on the promotion of a healthy lifestyle based on a varied and balanced diet and sufficient exercise. Our study showed that it is possible to improve lifestyle through educational events aimed at making students aware of the health risks deriving from unhealthy lifestyles.
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Affiliation(s)
- Fiorenzo Moscatelli
- Department of Clinical and Experimental Medicine, University of Foggia, 71013 Foggia, Italy
| | - Antonella De Maria
- Department of Experimental Medicine, Section of Human Physiology, Unit of Dietetics and Sports Medicine, Università degli Studi della Campania "Luigi Vanvitelli", 80131 Naples, Italy
| | | | - Vincenzo Monda
- Department of Movement Sciences and Wellbeing, University of Naples "Parthenope", 80133 Naples, Italy
| | - Antonietta Messina
- Department of Experimental Medicine, Section of Human Physiology, Unit of Dietetics and Sports Medicine, Università degli Studi della Campania "Luigi Vanvitelli", 80131 Naples, Italy
| | - Domenico Monacis
- Department of Humanities, Letters, Cultural Heritage, Educational Sciences, University of Foggia, 71100 Foggia, Italy
| | - Giusi Toto
- Department of Humanities, Letters, Cultural Heritage, Educational Sciences, University of Foggia, 71100 Foggia, Italy
| | - Pierpaolo Limone
- Department of Humanities, Telematic University "Pegaso", 80143 Naples, Italy
| | - Marcellino Monda
- Department of Experimental Medicine, Section of Human Physiology, Unit of Dietetics and Sports Medicine, Università degli Studi della Campania "Luigi Vanvitelli", 80131 Naples, Italy
| | - Giovanni Messina
- Department of Clinical and Experimental Medicine, University of Foggia, 71013 Foggia, Italy
| | - Antonietta Monda
- Department of Experimental Medicine, Section of Human Physiology, Unit of Dietetics and Sports Medicine, Università degli Studi della Campania "Luigi Vanvitelli", 80131 Naples, Italy
| | - Rita Polito
- Department of Clinical and Experimental Medicine, University of Foggia, 71013 Foggia, Italy
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11
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Kang J, Zhu X, Kan Y, Zhuang S. Application of the Knowledge, Attitude, and Practice model combined with motivational interviewing for health education in female patients with systemic lupus erythematosus. Medicine (Baltimore) 2023; 102:e33338. [PMID: 36961155 PMCID: PMC10036024 DOI: 10.1097/md.0000000000033338] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 03/01/2023] [Indexed: 03/25/2023] Open
Abstract
To explore the application effect of the Knowledge, Attitude, and Practice (KAP) model combined with motivational interviewing for health education in the chronic disease management of female patients with systemic lupus erythematosus (SLE). In this study, 84 women with SLE who were admitted to a tertiary hospital in Tianjin from July 2021 to April 2022 were enrolled in this study and divided into observation (n = 42) and control groups (n = 42). The control group received routine health education and treatment for chronic diseases. Based on the control group, the KAP method and questionnaire survey were adopted. Health literacy and compliance in the 2 groups were compared in the first and third months after the intervention. The observation group had a higher total score of health literacy in the third month than the control group. From before the intervention to the first and third months, improvement in the observation group was compared with that in the control group (F = 36.543, P 6..001; F = 4.884, P = .03; F = 23.881, P 3..001). The observation group had a higher total compliance score in the third month than the control group (t = 5.101, P = .007). From before the intervention to the first and third months of the intervention, the improvement in the observation group demonstrated an interaction with the time group compared with that in the control group (F = 68.116, P 8..001; F = 4.884, P = .032; F = 24.789, P < .001). Motivational interviewing based on the KAP model is effective in the short-term overall health literacy of female patients with SLE, especially in terms of communication, health improvement, and information acquisition; after 3 months, it can influence and maintain high patient compliance.
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Affiliation(s)
- Juan Kang
- Department of Nursing, Tianjin Medical University, Tianjin, China
| | - Xinran Zhu
- Department of Nursing, Tianjin Medical University, Tianjin, China
| | - Yan Kan
- Department of Rheumatology and Immunology, Tianjin First Central Hospital, Tianjin, China
| | - Shumei Zhuang
- Department of Nursing, Tianjin Medical University, Tianjin, China
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12
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Klaassen AE, Kapanen AI, Zed PJ, Conklin AI. Setting Goals to Reduce Cardiovascular Risk: A Retrospective Chart Review of a Pharmacist-Led Initiative in the Workplace. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:846. [PMID: 36613168 PMCID: PMC9820010 DOI: 10.3390/ijerph20010846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 12/11/2022] [Accepted: 12/27/2022] [Indexed: 06/17/2023]
Abstract
Background: Cardiovascular diseases (CVD) are the second leading cause of death in Canada with many modifiable risk factors. Pharmacists at a Canadian university delivered a novel CVD risk management program, which included goal-setting and medication management. Aim: This study aimed to describe what CVD prevention goals are composed of in a workplace CVD risk reduction program, and how might these goals change over time. Methods: A longitudinal, descriptive qualitative study using a retrospective chart review of clinical care plans for 15 patients enrolled in a CVD prevention program. Data across 6 visits were extracted from charts (n = 5413 words) recorded from May 2019-November 2020 and analyzed using quantitative content analysis and descriptive statistics. Results: Behavioural goals were most popular among patients and were more likely to change over the 12-month follow-up period, compared to health measure goals. Behavioural goals included goals around diet, physical activity (PA), smoking, medication, sleep and alcohol; health measure goals centered on weight measures, blood pressure (BP) and blood lipid levels. The most common behavioural goals set by patients were for diet (n = 11) and PA (n = 9). Over time, goals around PA, medication, alcohol and weight were adapted while others were added (e.g. diet) and some only continued. Patients experienced a number of barriers to their goal(s) which informed how they adapted their goal(s). These included environmental limitations (including COVID-19) and work-related time constraints. Conclusions: This study found CVD goal-setting in the pharmacist-led workplace wellness program was complex and evolved over time, with goals added and/or adapted. More detailed qualitative research could provide further insights into the patient-provider goal-setting experience in workplace CVD prevention.
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Affiliation(s)
- Alicia E. Klaassen
- Faculty of Pharmaceutical Sciences, The University of British Columbia, Vancouver, BC V6T 1Z3, Canada
| | - Anita I. Kapanen
- Faculty of Pharmaceutical Sciences, The University of British Columbia, Vancouver, BC V6T 1Z3, Canada
| | - Peter J. Zed
- Faculty of Pharmaceutical Sciences, The University of British Columbia, Vancouver, BC V6T 1Z3, Canada
- Department of Emergency Medicine, Faculty of Medicine, The University of British Columbia, Vancouver, BC V5Z 1M9, Canada
| | - Annalijn I. Conklin
- Faculty of Pharmaceutical Sciences, The University of British Columbia, Vancouver, BC V6T 1Z3, Canada
- Centre for Health Evaluation and Outcome Sciences (CHÉOS), St. Paul’s Hospital, Vancouver, BC V6Z IY6, Canada
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13
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Ivey SL, Hanley HR, Taylor C, Stock E, Vora N, Woo J, Johnson S, Bairey Merz CN. Early identification and treatment of women's cardiovascular risk factors prevents cardiovascular disease, saves lives, and protects future generations: Policy recommendations and take action plan utilizing policy levers. Clin Cardiol 2022; 45:1100-1106. [PMID: 36128629 DOI: 10.1002/clc.23921] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 08/15/2022] [Indexed: 11/10/2022] Open
Abstract
Cardiovascular diseases (CVD) including heart attacks, strokes, heart failure, and uncontrolled hypertension are leading causes of death among women of all ages. Despite efforts to increase awareness about CVD among women, over the past decade there has been stagnation in the reduction of CVD in women, and CVD among younger women and women of color has in fact increased. We recommend taking action using policy levers to address CVD in women including: (1) Promoting periodic screening for risk factors including blood pressure, lipids/cholesterol, diabetes for all women starting at 18-21 years, with calculated atherosclerotic CVD (ASCVD) risk score use among women 40 years or older. (2) Considering coronary artery calcium (CAC) screening for those with intermediate risk per current guidelines. (3) Enhancing Obstetrics and Gynecology and primary care physician education on reproductive age CVD risk markers, and that follow-up is needed, including extended postpartum follow-up. (4) Offering Health Coaching/motivational Interviewing to support behavior change. (5) Funding demonstration projects using different care models. (6) Creating a Stop High Blood Pressure consult line (for providers and patients) and providing other support resources with actions consumers can take, modeled after the California tobacco quit line. And (7) Requiring inclusion of adverse pregnancy outcomes in all Electronic Health Records, with reminder systems to follow-up on hypertension post-partum.
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Affiliation(s)
- Susan L Ivey
- UC Berkeley, School of Public Health, Berkeley, California, USA
| | | | - Catrina Taylor
- California Department of Public Health, Sacramento, California, USA
| | - Eveline Stock
- UCSF, School of Medicine, Cardiology, San Francisco, California, USA
| | - Nirali Vora
- School of Medicine, Neurology, Stanford University, Stanford, California, USA
| | - Jenny Woo
- UC Berkeley, School of Public Health, Berkeley, California, USA
| | - Sara Johnson
- Obstetrics and Gynecology, Alta Bates Summit Medical Center, Berkeley, California, USA
| | - C Noel Bairey Merz
- Barbra Streisand Women's Heart Center, Cedars-Sinai Medical Center, Smidt Heart Institute, Los Angeles, California, USA
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14
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Bernal-Jiménez MÁ, Calle-Pérez G, Gutiérrez-Barrios A, Gheorghe L, Solano-Mulero AM, Trujillo-Garrido N, Rodríguez-Martín A, Tur JA, Vázquez-García R, Santi-Cano MJ. Design and Validation of a Scale of Knowledge of Cardiovascular Risk Factors and Lifestyle after Coronary Event. J Clin Med 2022; 11:jcm11102773. [PMID: 35628900 PMCID: PMC9147543 DOI: 10.3390/jcm11102773] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 05/10/2022] [Accepted: 05/11/2022] [Indexed: 11/17/2022] Open
Abstract
Background: It is important for health professionals to have tools available to assess patients’ knowledge of lifestyle and cardiovascular risk factors after they have suffered a coronary event and determine whether educational interventions are effective. This study aims to design and validate a scale to evaluate this knowledge. Methods: Four-phase instrument design: (A) Conceptual review. (B) Review by experts. (C) Pilot test–retest. (D) Psychometric validation of the final version of the questionnaire with 24 items. A panel of experts performed the content validity. The reliability of the scale was measured using Cronbach’s alpha score and criterion validity was evaluated by comparing the total scores for knowledge obtained by the participants among the three education level groups. The construct and dimensional structure validity were assessed using exploratory factor analysis. Results: A total of 143 people participated, 30 in the pilot study and 113 (68% male, 60.2 ± 9 years) in the psychometric validation of version 3 of the scale. A Cronbach’s alpha score of 0.887 was reached for this version. The factor analysis showed that the items were distributed into five factors that explained 57% of the variance. Significant differences were observed in the level of knowledge among the patients of the three levels of education (low, moderate and high) (99.20 ± 11.93, 105.92 ± 7.85, 109.78 ± 8.76 points, p = 0.003), as there was a negative correlation between age and knowledge level (r = −0.213, p = 0.024). Conclusions: The scale presents psychometric properties that are evidence of its reliability and validity. The relationship demonstrated between the level of knowledge and age, sex and level of education shows the importance of emphasizing educational interventions for elderly people and those with a lower level of education.
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Affiliation(s)
- María Ángeles Bernal-Jiménez
- Faculty of Nursing and Physiotherapy, University of Cádiz, 11003 Cádiz, Spain; (M.Á.B.-J.); (N.T.-G.); (A.R.-M.)
- Institute of Biomedical Research and Innovation of Cádiz (INiBICA), 11009 Cádiz, Spain; (G.C.-P.); (A.G.-B.); (L.G.); (R.V.-G.)
- Research Group on Nutrition: Molecular, Pathophysiological and Social Issues, University of Cádiz, 11003 Cádiz, Spain
| | - Germán Calle-Pérez
- Institute of Biomedical Research and Innovation of Cádiz (INiBICA), 11009 Cádiz, Spain; (G.C.-P.); (A.G.-B.); (L.G.); (R.V.-G.)
- Cardiology Unit, Puerta del Mar Hospital, 11009 Cádiz, Spain;
| | - Alejandro Gutiérrez-Barrios
- Institute of Biomedical Research and Innovation of Cádiz (INiBICA), 11009 Cádiz, Spain; (G.C.-P.); (A.G.-B.); (L.G.); (R.V.-G.)
- Cardiology Unit, Puerta del Mar Hospital, 11009 Cádiz, Spain;
| | - Livia Gheorghe
- Institute of Biomedical Research and Innovation of Cádiz (INiBICA), 11009 Cádiz, Spain; (G.C.-P.); (A.G.-B.); (L.G.); (R.V.-G.)
- Cardiology Unit, Puerta del Mar Hospital, 11009 Cádiz, Spain;
| | | | - Nuria Trujillo-Garrido
- Faculty of Nursing and Physiotherapy, University of Cádiz, 11003 Cádiz, Spain; (M.Á.B.-J.); (N.T.-G.); (A.R.-M.)
- Institute of Biomedical Research and Innovation of Cádiz (INiBICA), 11009 Cádiz, Spain; (G.C.-P.); (A.G.-B.); (L.G.); (R.V.-G.)
- Research Group on Nutrition: Molecular, Pathophysiological and Social Issues, University of Cádiz, 11003 Cádiz, Spain
| | - Amelia Rodríguez-Martín
- Faculty of Nursing and Physiotherapy, University of Cádiz, 11003 Cádiz, Spain; (M.Á.B.-J.); (N.T.-G.); (A.R.-M.)
- Biomedicine, Biotechnology and Public Health Department, University of Cádiz, 11003 Cádiz, Spain
| | - Josep A. Tur
- Research Group on Community Nutrition & Oxidative Stress, University of the Balearic Islands-IUNICS, IDISBA & CIBEROBN, 07122 Palma de Mallorca, Spain;
| | - Rafael Vázquez-García
- Institute of Biomedical Research and Innovation of Cádiz (INiBICA), 11009 Cádiz, Spain; (G.C.-P.); (A.G.-B.); (L.G.); (R.V.-G.)
- Cardiology Unit, Puerta del Mar Hospital, 11009 Cádiz, Spain;
| | - María José Santi-Cano
- Faculty of Nursing and Physiotherapy, University of Cádiz, 11003 Cádiz, Spain; (M.Á.B.-J.); (N.T.-G.); (A.R.-M.)
- Institute of Biomedical Research and Innovation of Cádiz (INiBICA), 11009 Cádiz, Spain; (G.C.-P.); (A.G.-B.); (L.G.); (R.V.-G.)
- Research Group on Nutrition: Molecular, Pathophysiological and Social Issues, University of Cádiz, 11003 Cádiz, Spain
- Correspondence: ; Tel.: +34-956-019042; Fax: +34-956-015685
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15
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Mifsud JL, Galea J. Motivational interviewing and outcomes in primary preventive cardiology. THE BRITISH JOURNAL OF CARDIOLOGY 2021; 28:47. [PMID: 35747071 PMCID: PMC9063703 DOI: 10.5837/bjc.2021.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Affiliation(s)
| | - Joseph Galea
- Associate Professor Faculty of Medicine and Surgery, University of Malta, Msida, Malta
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16
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Duffy EY, Ashen D, Blumenthal RS, Davis DM, Gulati M, Blaha MJ, Michos ED, Nasir K, Cainzos‐Achirica M. Communication approaches to enhance patient motivation and adherence in cardiovascular disease prevention. Clin Cardiol 2021; 44:1199-1207. [PMID: 34414588 PMCID: PMC8427972 DOI: 10.1002/clc.23555] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 01/13/2021] [Accepted: 01/20/2021] [Indexed: 12/25/2022] Open
Abstract
Preventive cardiology visits have traditionally focused on educating patients about disease risk factors and the need to avoid and manage them through lifestyle changes and medications. However, long-term patient adherence to the recommended interventions remains a key unmet need. In this review we discuss the rationale and potential benefits of a paradigm shift in the clinician-patient encounter, from focusing on education to explicitly discussing key drivers of individual motivation. This includes the emotional, psychological, and economic mindset that patients bring to their health decisions. Five communication approaches are proposed that progress clinician-patient preventive cardiology conversations, from provision of information to addressing values and priorities such as common health concerns, love for the family, desire of social recognition, financial stressors, and desire to receive personalized advice. Although further research is needed, these approaches may facilitate developing deeper, more effective bonds with patients, enhance adherence to recommendations and ultimately, improve cardiovascular outcomes.
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Affiliation(s)
- Eamon Y. Duffy
- Department of Internal MedicineJohns Hopkins University School of MedicineBaltimoreMarylandUSA
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Division of CardiologyJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Dominique Ashen
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Division of CardiologyJohns Hopkins University School of MedicineBaltimoreMarylandUSA
- School of NursingJohns Hopkins UniversityBaltimoreMarylandUSA
| | - Roger S. Blumenthal
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Division of CardiologyJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Dorothy M. Davis
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Division of CardiologyJohns Hopkins University School of MedicineBaltimoreMarylandUSA
- School of NursingJohns Hopkins UniversityBaltimoreMarylandUSA
| | - Martha Gulati
- University of Arizona College of MedicinePhoenixArizonaUSA
- Banner University Medical CenterPhoenixArizonaUSA
| | - Michael J. Blaha
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Division of CardiologyJohns Hopkins University School of MedicineBaltimoreMarylandUSA
- Welch Center for Prevention, Epidemiology and Clinical ResearchJohns Hopkins UniversityBaltimoreMarylandUSA
- Department of EpidemiologyJohns Hopkins Bloomberg School of Public Health, Johns Hopkins UniversityBaltimoreMarylandUSA
| | - Erin D. Michos
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Division of CardiologyJohns Hopkins University School of MedicineBaltimoreMarylandUSA
- Welch Center for Prevention, Epidemiology and Clinical ResearchJohns Hopkins UniversityBaltimoreMarylandUSA
- Department of EpidemiologyJohns Hopkins Bloomberg School of Public Health, Johns Hopkins UniversityBaltimoreMarylandUSA
| | - Khurram Nasir
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Division of CardiologyJohns Hopkins University School of MedicineBaltimoreMarylandUSA
- Division of Cardiovascular Prevention and Wellness, Department of CardiologyHouston Methodist DeBakey Heart & Vascular CenterHoustonTexasUSA
- Center for Outcomes ResearchHouston MethodistHoustonTexasUSA
| | - Miguel Cainzos‐Achirica
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Division of CardiologyJohns Hopkins University School of MedicineBaltimoreMarylandUSA
- Division of Cardiovascular Prevention and Wellness, Department of CardiologyHouston Methodist DeBakey Heart & Vascular CenterHoustonTexasUSA
- Center for Outcomes ResearchHouston MethodistHoustonTexasUSA
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17
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Mifsud JL, Stephenson J, Astin F, Galea J. Coronary risk reduction intervention for siblings and offspring of patients with premature coronary heart disease: the CRISO study protocol for a randomised controlled pilot study. Pilot Feasibility Stud 2021; 7:153. [PMID: 34372930 PMCID: PMC8351410 DOI: 10.1186/s40814-021-00874-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 06/21/2021] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Research has consistently demonstrated that preventive cardiology programs have limited success, and healthy practices among high-risk individuals remain suboptimal. Furthermore, there are no current programmes in Malta that offer support to first-degree relatives of patients with premature coronary heart disease. This internal pilot study will determine the feasibility, acceptability, and potential effectiveness of a preventative intervention. METHODS/DESIGN We are conducting a 12-month single-centre, two-armed group randomised controlled trial (RCT), recruiting a sample of 100 asymptomatic first-degree relatives of patients with premature coronary heart disease (CHD). The study seeks to test an evidence-based intervention to reduce modifiable risk and determine its feasibility and acceptability. The Intervention will be delivered at an outpatient office based in a large acute academic hospital. It will comprise risk communication using an online risk calculator, a counselling style adapted from motivational interviewing, and 12 weekly telephone goal reinforcement calls (3 months). Control subjects will receive verbal lifestyle advice only. Feasibility will be assessed through recruitment and retention. Qualitative evaluation interviews will be conducted with a subsample of 24 purposefully selected participants at 12 months. Assessment for risk factor changes will be measured at pre-intervention and 6 and 12 months. Associations between variables will also be assessed descriptively. DISCUSSION Preventive cardiology guidelines highlighted the importance of lifestyle interventions, and lifestyle intervention adherence was proven to reduce atherosclerotic cardiovascular disease (ASCVD) risk, regardless of the individual's genetic risk. Preventive cardiology programmes may fail to adequately support persons in modifying risky behaviours, and research demonstrates that healthy practices among high-risk individuals can remain suboptimal. Siblings and offspring of patients with premature CHD are at increased risk of ASCVD. Despite this, there is no process in place for routine screening and support to modify risk. It is hypothesised that participants assigned to the intervention arm will show more cardio-protective lifestyle-related improvement from the baseline than those in the control group. To date, this is the first trial being conducted amongst Maltese first-degree relatives. This study addresses the needed research, and the results will inform a definitive trial. The funding institution is the University of Malta. TRIAL REGISTRATION ISRCTN, ISRCTN21559170 ; Registered 06/08/2020.
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Affiliation(s)
- Justin Lee Mifsud
- Faculty of Health Sciences, University of Malta, Msida, Malta.
- Faculty of Medicine and Surgery, University of Malta, Msida, Malta.
| | - John Stephenson
- School of Human of Health Sciences, University of Huddersfield, Huddersfield, UK
| | - Felicity Astin
- School of Human of Health Sciences, University of Huddersfield, Huddersfield, UK
- Research and Development, Huddersfield Royal Infirmary, Acre St, Huddersfield, UK
| | - Joseph Galea
- Faculty of Medicine and Surgery, University of Malta, Msida, Malta
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18
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Bravo JJM. [Importance of adherence to healthy lifestyles in people with diabetes]. Semergen 2021; 47:141-143. [PMID: 33975690 DOI: 10.1016/j.semerg.2021.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 04/15/2021] [Indexed: 10/21/2022]
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19
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Ghizzardi G, Arrigoni C, Dellafiore F, Vellone E, Caruso R. Efficacy of motivational interviewing on enhancing self-care behaviors among patients with chronic heart failure: a systematic review and meta-analysis of randomized controlled trials. Heart Fail Rev 2021; 27:1029-1041. [PMID: 33866487 DOI: 10.1007/s10741-021-10110-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/13/2021] [Indexed: 12/28/2022]
Abstract
Although motivational interviewing (MI) seems to be promising for enhancing self-care behaviors (i.e., daily disease management and responses to symptoms) in patients with heart failure (HF), no quantitative pooling of effect sizes has been described to summarize and test its efficacy on self-care. Given that self-care behaviors of patients with HF are essential to enhance pharmacological adherence and disease management and optimize clinical outcomes, we sought to perform a systematic review of randomized control trials (RCTs) regarding MI's efficacy on enhancing self-care behaviors among patients with HF, synthesizing MI effects on self-care through meta-analyses. Nine randomized controlled trials were included. MI showed moderate effects on enhancing self-care confidence (Hedge's g = 0.768; 95%CI = 0.326-1.210; P = 0.001) and self-care management (i.e., responses to symptoms) (Hedge's g = 0.744; 95%CI = 0.256-1.232; P = 0.003) and large effects on improving self-care maintenance (i.e., adherence to treatment and symptom monitoring) (Hedge's g = 0.873; 95%CI = 0.430-1.317; P < 0.001). No significant effects were found for enhancing the self-reported physical functioning (Hedge's g = -0.385; 95%CI = -1.063-0.294; P = 0.267) or the directly assessed physical functioning using the 6-min walking test (Hedge's g = -0.131; 95%CI = -0.981-0.720; P = 0.072). Although future research is still required to identify situation-specific indications regarding how MI should be implemented in relation to specific clinical conditions, this study showed that MI is an effective strategy to improve self-care in patients with HF.
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Affiliation(s)
- Greta Ghizzardi
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Cristina Arrigoni
- Department of Public Health, Experimental and Forensic Medicine, Section of Hygiene, University of Pavia, Pavia, Italy
| | - Federica Dellafiore
- Department of Public Health, Experimental and Forensic Medicine, Section of Hygiene, University of Pavia, Pavia, Italy
| | - Ercole Vellone
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Rosario Caruso
- Health Professions Research and Development Unit, IRCCS Policlinico San Donato, San Donato Milanese, Italy.
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20
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Lo YP, Chiang SL, Lin CH, Liu HC, Chiang LC. Effects of Individualized Aerobic Exercise Training on Physical Activity and Health-Related Physical Fitness among Middle-Aged and Older Adults with Multimorbidity: A Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 18:ijerph18010101. [PMID: 33375668 PMCID: PMC7794827 DOI: 10.3390/ijerph18010101] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 12/22/2020] [Accepted: 12/23/2020] [Indexed: 12/21/2022]
Abstract
The presence of multimorbidity in middle-aged and older adults, which reduces their physical activity and quality of life, is a global health challenge. Exercise is one of the most important health behaviors that individuals can engage in. Previous studies have revealed that aerobic exercise training is beneficial for healthy middle-aged and older adults and those with various chronic diseases, but few studies have designed individualized aerobic exercise training for individuals with multimorbidity. Although individuals with multimorbidity are considerably less adherent to physical activity interventions, telephone-based motivational interviewing may help in strengthening motivation and promoting behavioral change for increasing physical activity and health-related physical fitness. This study aimed to examine whether a 12-week individualized aerobic exercise training in a rehabilitation center combined with telephone-based motivational interviewing is effective in promoting physical activity and health-related physical fitness among middle-aged and older adults with multimorbidity. A randomized controlled trial was conducted. Forty-three participants (aged > 40) were recruited and randomly assigned to the intervention group, comparison group, or control group. The participants’ physical activity and health-related physical fitness were assessed at baseline and at 12 weeks. The results indicated that after individualized aerobic exercise training combined with telephone-based motivational interviewing, the participants reported increased total physical activity (Fin = 481.3, p = 0.011), vigorous-intensity physical activity (Fin= 298.9, p = 0.007), dominant and nondominant hand grip (kg) (Fin = 1.96, p = 0.019; Fin = 2.19, p = 0.027, respectively), FEV1/FVC (Fin = 0.045, p = 0.043), VO2 max (ml/kg/min) (Fin = 5.30, p = 0.001), VO2 max predicted (%) (Fin = 21.6, p = 0.001), work (watts) (Fin = 22.5, p = 0.001), and anaerobic threshold (L/min) (Fin = 0.165, p = 0.011). Twelve weeks of individualized aerobic exercise training in the rehabilitation center combined with telephone-based motivational interviewing can increase the total physical activity, vigorous physical activity, and cardiorespiratory fitness of middle-aged and older adults with multimorbidity.
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Affiliation(s)
- Yi-Pang Lo
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei 11490, Taiwan;
- Department of Nursing, Tri-Service General Hospital SongShan Branch, Taipei 10581, Taiwan;
| | - Shang-Lin Chiang
- School of Medicine, National Defense Medical Center, Taipei 11490, Taiwan;
- Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, Taipei 11490, Taiwan;
| | - Chia-Huei Lin
- Department of Nursing, Tri-Service General Hospital SongShan Branch, Taipei 10581, Taiwan;
- School of Nursing, National Defense Medical Center, Taipei 11490, Taiwan
| | - Hung-Chang Liu
- Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, Taipei 11490, Taiwan;
| | - Li-Chi Chiang
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei 11490, Taiwan;
- School of Nursing, National Defense Medical Center, Taipei 11490, Taiwan
- School of Nursing, China Medical University, Taichung 40402, Taiwan
- Correspondence:
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