健康教育干预对PCI术后冠心病危险因素影响的效果评价
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摘要
研究目的探讨多学科合作、多形式共用、医院与社区相结合的长期综合健康教育干预能否有效控制PCI术后病人冠心病危险因素,为PCI术后的二级预防工作提供参考依据。
研究方法采取同期随机对照试验,研究对象选取山西省三所三级甲等医院2006年11月1日~11月30日期间,成功实施PCI手术的太原市区病人。获得知情同意后,采用分层随机化,将病人随机分为干预组和对照组;干预组接受综合健康教育,对照组接受常规健康教育。统一调查和体检收集病人的一般资料、药物服用情况、冠心病危险因素水平资料;以ACC/AHA2005/2007年PCI治疗指南和WHO推荐的PCI术后冠心病危险因素应控制的目标水平为干预效果判断标准。用两样本t检验、秩和检验、卡方检验分析两组病人一般资料、冠心病危险因素基线水平、基线药物服用情况的组间均衡可比性。用单因素分析(卡方检验、分层卡方检验)和多因素分析(非条件logistic回归)进行统计学处理,排除6个月后/12个月后药物治疗的混杂因素后,干预对6个月后、12个月后冠心病危险因素控制达标率与对照组有无差别。
结果两组病人的一般资料、冠心病危险因素基线水平、基线药物服用情况经统计学处理,无组间差异,均衡可比。干预6个月后,经卡方检验,干预组LDL-C、BMI、WC、运动达标率高于对照组,BP、FB、戒烟达标率与对照组无差别;单因素和多因素分析结果显示:排除6个月后药物治疗的混杂因素后,综合健康教育干预对LDL-C、BMI、WC、运动不足4个冠心病危险因素达标率有影响。干预12个月后,经卡方检验,干预组BP、LDL-C、FB、BMI、WC、戒烟、运动达标率均高于对照组,单因素和多因素分析结果显示:排除12个月后药物治疗的混杂作用后,综合健康教育干预对BP、LDL-C、BMI、WC、吸烟、运动不足6个冠心病危险因素达标率有影响,对FB控制与常规健康教育无差别。
结论干预6个月后,综合健康教育对PCI术后LDL-C、BMI、WC、运动不足4个冠心病危险因素控制效果可以肯定;干预12个月后,综合健康教育对PCI术后BP、LDL-C、BMI、WC、运动不足、吸烟6个冠心病危险因素控制效果可以肯定;综合健康教育干预对FB控制效果与常规健康教育无差别。长期健康教育干预效果可能优于短期,其结论需进一步证明。
Objective: The objective of the present study was to determine whether a long-term comprehensive health intervention programme with a dedicated medical director, along with an interdisciplinary team approach, including hospital and community could favourably influence coronary risk factors(CRF) in patients after percutaneous coronary intervention and improvement Secondary prevention interventions for patients after PCI.
Methods: Concurrent randomized control trials were conducted in this study. A consecutive series of eligible patients was recruited from three hospitals in Tai yuan city, shan xi province, China after their first percutaneous coronary intervention between November 1 and November 30, 2006. After obtaining informed consent, a total of 127 patients after PCI were included and randomised to a comprehensive intervention programme(IP) or to usual care(UC). Both groups were given the same comprehensive medication. At baseline all participants were asked to offer their demographic, medication status and underwent risk factor assessment (physical and laboratory examination). After a period of 6 months and 12 months of intervention, all participants were invited to undertaken the same factor assessment as baseline successively. 2007 AHA/ACC PCI Secondary Prevention Guidelines and relative recommendations of WHO were selected as the criterion of evaluation. Independent sample t-tests, wilcoxon rank sum test, Chi-square test were used to evaluate differences in basic demographic, medical characteristics and coronary risk factors between the two study groups. univariate analyses, The [chi]2 statistic and Mantel-Haenszel were used to identify intervention, medical characteristics associated with effectiveness rates of CRF controlled of 6 months later and 12months later. Logistic regression was computed to evaluated the effectiveness of intervention in coronary risk reduction. Level of significance for all tests is P=0.05 (two-tailed).
Results: There were no differences between the two groups in baseline sociodemographic, medical characteristics or risk factors, suggesting that there was no systematic bias attributable to differences in the intervals to the follow-up interviews. In the univariate analyses, IP and medication after 6 months were associated with effectiveness rates of controlling LDL-C, BMI, WC, physical activity. When all the relative variables were entered into a logistic regression analysis, IP emerged as significant in increasing the likelihood of managing LDL-C, BMI, WC, physical activity. IP after 12 months was associated with effectiveness rates of controlling all seven CRFs. When all the relative variables were entered into a logistic regression analysis, IP emerged as significant in increasing the likelihood of standard managing all seven CRFs except FB.
Conclusion: compared with usual care, comprehensive health intervention seems a more effective way to improved CRFs modification after PCI. This programme provide a method of prevention to decrease the rate of restenosis and further cardiovascular events.
研究方法采取同期随机对照试验,研究对象选取山西省三所三级甲等医院2006年11月1日~11月30日期间,成功实施PCI手术的太原市区病人。获得知情同意后,采用分层随机化,将病人随机分为干预组和对照组;干预组接受综合健康教育,对照组接受常规健康教育。统一调查和体检收集病人的一般资料、药物服用情况、冠心病危险因素水平资料;以ACC/AHA2005/2007年PCI治疗指南和WHO推荐的PCI术后冠心病危险因素应控制的目标水平为干预效果判断标准。用两样本t检验、秩和检验、卡方检验分析两组病人一般资料、冠心病危险因素基线水平、基线药物服用情况的组间均衡可比性。用单因素分析(卡方检验、分层卡方检验)和多因素分析(非条件logistic回归)进行统计学处理,排除6个月后/12个月后药物治疗的混杂因素后,干预对6个月后、12个月后冠心病危险因素控制达标率与对照组有无差别。
结果两组病人的一般资料、冠心病危险因素基线水平、基线药物服用情况经统计学处理,无组间差异,均衡可比。干预6个月后,经卡方检验,干预组LDL-C、BMI、WC、运动达标率高于对照组,BP、FB、戒烟达标率与对照组无差别;单因素和多因素分析结果显示:排除6个月后药物治疗的混杂因素后,综合健康教育干预对LDL-C、BMI、WC、运动不足4个冠心病危险因素达标率有影响。干预12个月后,经卡方检验,干预组BP、LDL-C、FB、BMI、WC、戒烟、运动达标率均高于对照组,单因素和多因素分析结果显示:排除12个月后药物治疗的混杂作用后,综合健康教育干预对BP、LDL-C、BMI、WC、吸烟、运动不足6个冠心病危险因素达标率有影响,对FB控制与常规健康教育无差别。
结论干预6个月后,综合健康教育对PCI术后LDL-C、BMI、WC、运动不足4个冠心病危险因素控制效果可以肯定;干预12个月后,综合健康教育对PCI术后BP、LDL-C、BMI、WC、运动不足、吸烟6个冠心病危险因素控制效果可以肯定;综合健康教育干预对FB控制效果与常规健康教育无差别。长期健康教育干预效果可能优于短期,其结论需进一步证明。
Objective: The objective of the present study was to determine whether a long-term comprehensive health intervention programme with a dedicated medical director, along with an interdisciplinary team approach, including hospital and community could favourably influence coronary risk factors(CRF) in patients after percutaneous coronary intervention and improvement Secondary prevention interventions for patients after PCI.
Methods: Concurrent randomized control trials were conducted in this study. A consecutive series of eligible patients was recruited from three hospitals in Tai yuan city, shan xi province, China after their first percutaneous coronary intervention between November 1 and November 30, 2006. After obtaining informed consent, a total of 127 patients after PCI were included and randomised to a comprehensive intervention programme(IP) or to usual care(UC). Both groups were given the same comprehensive medication. At baseline all participants were asked to offer their demographic, medication status and underwent risk factor assessment (physical and laboratory examination). After a period of 6 months and 12 months of intervention, all participants were invited to undertaken the same factor assessment as baseline successively. 2007 AHA/ACC PCI Secondary Prevention Guidelines and relative recommendations of WHO were selected as the criterion of evaluation. Independent sample t-tests, wilcoxon rank sum test, Chi-square test were used to evaluate differences in basic demographic, medical characteristics and coronary risk factors between the two study groups. univariate analyses, The [chi]2 statistic and Mantel-Haenszel were used to identify intervention, medical characteristics associated with effectiveness rates of CRF controlled of 6 months later and 12months later. Logistic regression was computed to evaluated the effectiveness of intervention in coronary risk reduction. Level of significance for all tests is P=0.05 (two-tailed).
Results: There were no differences between the two groups in baseline sociodemographic, medical characteristics or risk factors, suggesting that there was no systematic bias attributable to differences in the intervals to the follow-up interviews. In the univariate analyses, IP and medication after 6 months were associated with effectiveness rates of controlling LDL-C, BMI, WC, physical activity. When all the relative variables were entered into a logistic regression analysis, IP emerged as significant in increasing the likelihood of managing LDL-C, BMI, WC, physical activity. IP after 12 months was associated with effectiveness rates of controlling all seven CRFs. When all the relative variables were entered into a logistic regression analysis, IP emerged as significant in increasing the likelihood of standard managing all seven CRFs except FB.
Conclusion: compared with usual care, comprehensive health intervention seems a more effective way to improved CRFs modification after PCI. This programme provide a method of prevention to decrease the rate of restenosis and further cardiovascular events.
引文
[1]叶任高,陆再英.内科学,第5版,人民卫生出版社:237~239
[2] Mathers C, Bernard C, Iburg K, et al. Global Burden of Disease in 2002: Data Sources, Methods and Results. GPE Discussion Paper No. 54. Geneva: World Health Organization; 2004.
[3] Tod AM, Lacey EA, McNeill F. 'I'm still waiting[horizontal ellipsis]:barriers to accessing cardiac rehabilitation services. J Adv Nurs. 2002;40:421-431.
[4] Cannon RO 3rd. Restenosis after angioplasty. N Engl J Med. 2002;346:1182-1183. Bibliographic Links Document Delivery Library Holdings.
[5] Higgins, Rosemary O. Expressed preferences for health education of patients after percutaneous coronary intervention. European Journal of Cardiovascular Prevention(C) 2005 European Society of Cardiology, Volume 12(6), December 2005, pp 572-579
[6]胡大一.心脏病人精神卫生培训教程.人民军医出版社:117
[7] Lisspers J, Sundin O, Ohman A, Hofman-Bang C, Ryden L, Nygren A. Long-term effects of lifestyle behavior change in coronary artery disease: effects on recurrent coronary events after percutaneous coronary intervention. Health Psychol. 2005;24:41-48.
[8]黄悦勤主编,李立明主审。临床流行病学,人民卫生出版社:67
[9]于全俊,王苏中,等。冠心病防治指南。人民卫生出版社,2003:3~5
[10] Sullivan MD, LaCroix AZ, Spertus JA, Hecht J, Russo J. Depression predicts revascularization procedures for 5 years after coronary angiography. Psychosom Med. 2003;65:229-236. Ovid Full Text Bibliographic Links Document Delivery Library Holdings
[11] Worcester M, Mee V, Murphy B, Roberts S, Goble A. Cardiac rehabilitation programs: predictors of non-attendance and drop-out. Eur J Cardiovasc Prev Rehabil 2004; 11:328-335.
[12] Fernandez, Ritin S. Persistence of Coronary Risk Factor Status in Participants 12 to 18 Months After Percutaneous Coronary Intervention. The Journal of Cardiovascular Nursing(C) 2006 Lippincott Williams & Wilkins, Inc. Volume 21(5), September/October 2006, pp 379-387
[13] 2007 Writing Group. 2007 Focused Update of the ACC/AHA/SCAI 2005 Guideline Update for Percutaneous Coronary Intervention: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines
[14] Samaha, Frederick F. New International Measuring Stick for Defining Obesity in Non-Europeans,Circulation,Issue:Volume 115(16), 24 April 2007, pp 2089-2090 Publisher:(C) 2007 American Heart Association, Inc.
[15] Mittag, Oskara; Outcomes of cardiac rehabilitation with versus without a follow-up intervention rendered by telephone (Luebeck follow-up trial): overall and gender-specific effects[Original articles] International Journal of Rehabilitation Research(C) 2006 Lippincott Williams & Wilkins, Inc. Volume 29(4), December 2006, pp 295-302
[16] Lisspers, Jan Long-Term Effects of Lifestyle Behavior Change in Coronary Artery Disease: Effects on Recurrent Coronary Events After Percutaneous Coronary Intervention.[Article] Health Psychology, January 2005.24(1):41-48
[17] Vale, Margarite J. Impact of Coaching Patients on Coronary Risk Factors: Lessons from The COACH Program.[Review] Disease Management & Health Outcomes. 13(4):225-244, 2005.
[18] Cobb, Stephanie L. Effective interventions for lifestyle change after myocardial infarction or coronary artery revascularization.[Review] Journal of the American Academy of Nurse Practitioners.18(1):31-39, January 2006.
[19] Erbs, Sandra.Effects of exercise training on mortality in patients with coronary heart disease Coronary Artery Disease(C) 2006 Lippincott Williams & Wilkins, Inc. Volume 17(3), May 2006, pp 219-225
[20] Lip, G YH 1 Ethnicity and cardiovascular disease prevention in the United Kingdom: a practical approach to management.[Review] Journal of Human Hypertension. 21(3):183-211, March 2007.
[21] Guiducci, Umberto What to suggest after coronary angioplasty or bypass surgery procedures: a sedentary lifestyle, moderate physical activity or sports activity? [Controversial and emerging problems in sports cardiology] Journal of Cardiovascular Medicine (C) 2006 Italian Federation of CardiologyVolume 7(4), April 2006, p 296-300
[22] Parkosewich, Janet A. Cardiac Rehabilitation Barriers and Opportunities Among Women With Cardiovascular Disease[Review Article] Cardiology in Review (C) 2008 Lippincott Williams & Wilkins, Inc.Volume 16(1), January/February 2008, pp 36-52
[23] Watson, Karol MD. Managing Cardiometabolic Risk: An Evolving Approach to Patient Care[Original Article] Critical Pathways in Cardiology: A Journal of Evidence-Based Medicine (C) 2007 Lippincott Williams & Wilkins, Inc.Volume 6(1), March 2007, pp 5-14
[24]赵菲,邝碧娟,曾丽吟,.冠心病二级预防中干预模式的应用研究,护理学杂志2004年8月第19卷第15期(综合版):7-10
[25]郭兰.冠心病人的心脏康复治疗和生命网.中国医药导刊,2004年第6卷第5期(总第34期):389-390
[26]邝碧娟,赵菲,曾丽吟,王湘郴,包世敏。健康教育在冠心病二级预防中的作用.现代护理,2006年第12卷第16期:1551-1552
[27]刘永平,郑兴。康复锻炼对冠心病二级预防的作用。中国老年医学杂志2007年2月第27卷:398-400
[28]刘义富,冯雪梅.康复治疗对冠心病介入治疗疗效的影响.医师进修杂志2005年4月第28卷第4期内科版:38-39
[29]黄华.电话回访式健康教育在心脏介入手术患者中的应用.实用心脑肺血管病杂志2006年5月第14卷第5期:415.
[30]赵菲,胡淑芬,吴焰.冠心病介入治疗康复现状.护理研究,2006年4月第20卷第4期下旬版(总第176期):1038-1039
[31] Worcester, Marian Una Christine PhD, MA, BA; Stojcevski, Zlatko MEd Psych, BSc,Grad Dip App Psych: Long-term Behavioral Outcomes After Attendance at a Secondary Prevention Clinic for Cardiac Patients, Journal of Cardiopulmonary Rehabilitation(C) 2003 Lippincott Williams & Wilkins, Inc. Volume 23(6), November/December 2003, pp 415-422
[32] Correspondence and requests for reprints to Jan Erik Otterstad, MD, FESC, Influence on lifestyle measures and five-year coronary risk by a comprehensivelifestyle intervention p rogramme in patients with coronary heart disease, European Journal of Cardiovascular Prevention & Rehabilitation (C) 2003 European Society of Cardiology,Volume 10(6), December 2003, pp 429-437
[33] Goble AJ, Worcester MUC. Best Practice Guidelines for Cardiac Rehabilitation and Secondary Prevention. Melbourne Victoria, Australia: Heart Research Centre, Department of Human Services; 1999.
[34] Long-term Behavioral Outcomes After Attendance at a Secondary Prevention Clinic for Cardiac Patients Journal of Cardiopulmonary Rehabilitation (C) 2003 Lippincott Williams & Wilkins, Inc.Volume 23(6), November/December 2003, pp 415-422
[35]魏本领,冠心病患者康复期安全运动耐量的评估.海军医学杂志2004年9月第25卷第3期:223~224
[1] Mathers C, Bernard C, Iburg K, et al. Global Burden of Disease in 2002: Data Sources, Methods and Results. GPE Discussion Paper No. 54. Geneva: World Health Organization; 2004.
[2] Tod AM, Lacey EA, McNeill F. 'I'm still waiting[horizontal ellipsis]:barriers to accessing cardiac rehabilitation services. J Adv Nurs. 2002;40:421-431.
[3] Cannon RO 3rd. Restenosis after angioplasty. N Engl J Med. 2002;346:1182-1183. Bibliographic Links Document Delivery Library Holdings.
[4] Higgins, Rosemary O. Expressed preferences for health education of patients after percutaneous coronary intervention. European Journal of Cardiovascular Prevention(C) 2005 European Society of Cardiology, Volume 12(6), December 2005, pp 572-579
[5] Lisspers J, Sundin O, Ohman A, Hofman-Bang C, Ryden L, Nygren A. Long-term effects of lifestyle behavior change in coronary artery disease: effects on recurrent coronary events after percutaneous coronary intervention. Health Psychol. 2005;24:41-48.
[6]张光明,魏承承毓.预防冠心病相关因素的研究进展.国外医学·社会医学分册,2002年3月第19卷第1期:32-35
[7] Edwards R. The problem of tobacco smoking. Br Med J. 2004;328:217-219. Ovid Full Text Bibliographic Links Document Delivery Library Holdings
[8] Grundy SM, Cleeman JI, Merz CN, et al. Implications of recent clinical trials for the National Cholesterol Education Program Adult Treatment Panel III guidelines. Circulation. 2004;110:227-239. Ovid Full Text Bibliographic Links Document Delivery Library Holdings
[9]王宏宇,胡大一.冠心病二级预防策略.中国医刊,2003年第38卷第7期(总445):61-62.
[10] Sullivan MD, LaCroix AZ, Spertus JA, Hecht J, Russo J. Depression predicts revascularization procedures for 5 years after coronary angiography. Psychosom Med. 2003;65:229-236. Ovid Full Text Bibliographic Links Document Delivery Library Holdings
[11] 2007 Writing Group. 2007 Focused Update of the ACC/AHA/SCAI 2005 Guideline Update for Percutaneous Coronary Intervention: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines [PCI Focused Update] Circulation(C) 2008 American Heart Association, Inc. Volume 117(2), 15 January 2008, pp 261-295
[12] Fernandez, Ritin S. Persistence of Coronary Risk Factor Status in Participants 12 to 18 Months After Percutaneous Coronary Intervention. The Journal of Cardiovascular Nursing(C) 2006 Lippincott Williams & Wilkins, Inc. Volume 21(5), September/October 2006, pp 379-387
[13] Worcester M, Mee V, Murphy B, Roberts S, Goble A. Cardiac rehabilitation programs: predictors of non-attendance and drop-out. Eur J Cardiovasc Prev Rehabil 2004; 11:328-335.
[14] Mittag, Oskara; Outcomes of cardiac rehabilitation with versus without a follow-upintervention rendered by telephone (Luebeck follow-up trial): overall and gender-specific effects[Original articles] International Journal of Rehabilitation Research(C) 2006 Lippincott Williams & Wilkins, Inc. Volume 29(4), December 2006, pp 295-302
[15] Lisspers, Jan Long-Term Effects of Lifestyle Behavior Change in Coronary Artery Disease: Effects on Recurrent Coronary Events After Percutaneous Coronary Intervention.[Article] Health Psychology, January 2005.24(1):41-48
[16] Vale, Margarite J. Impact of Coaching Patients on Coronary Risk Factors: Lessons from The COACH Program.[Review] Disease Management & Health Outcomes. 13(4):225-244, 2005.
[17] Cobb, Stephanie L. Effective interventions for lifestyle change after myocardial infarction or coronary artery revascularization.[Review] Journal of the American Academy of Nurse Practitioners.18(1):31-39, January 2006.
[18] Erbs, Sandra.Effects of exercise training on mortality in patients with coronary heart disease Coronary Artery Disease(C) 2006 Lippincott Williams & Wilkins, Inc. Volume 17(3), May 2006, pp 219-225
[19] Lip, G YH 1 Ethnicity and cardiovascular disease prevention in the United Kingdom: a practical approach to management.[Review] Journal of Human Hypertension. 21(3):183-211, March 2007.
[20] Guiducci, Umberto What to suggest after coronary angioplasty or bypass surgery procedures: a sedentary lifestyle, moderate physical activity or sports activity? [Controversial and emerging problems in sports cardiology] Journal of Cardiovascular Medicine (C) 2006 Italian Federation of CardiologyVolume 7(4), April 2006, p 296-300
[21] Parkosewich, Janet A. Cardiac Rehabilitation Barriers and Opportunities Among Women With Cardiovascular Disease[Review Article] Cardiology in Review (C) 2008 Lippincott Williams & Wilkins, Inc.Volume 16(1), January/February 2008, pp 36-52
[22] Watson, Karol MD. Managing Cardiometabolic Risk: An Evolving Approach to Patient Care[Original Article] Critical Pathways in Cardiology: A Journal of Evidence-Based Medicine (C) 2007 Lippincott Williams & Wilkins, Inc.Volume 6(1), March 2007, pp 5-14
[23]赵菲,邝碧娟,曾丽吟,.冠心病二级预防中干预模式的应用研究,护理学杂志2004年8月第19卷第15期(综合版):7-10
[24]郭兰.冠心病人的心脏康复治疗和生命网.中国医药导刊,2004年第6卷第5期(总第34期):389-390
[25]邝碧娟,赵菲,曾丽吟,王湘郴,包世敏。健康教育在冠心病二级预防中的作用.现代护理,2006年第12卷第16期:1551-1552
[26]刘永平,郑兴。康复锻炼对冠心病二级预防的作用。中国老年医学杂志2007年2月第27卷:398-400
[27]刘义富,冯雪梅.康复治疗对冠心病介入治疗疗效的影响.医师进修杂志2005年4月第28卷第4期内科版:38-39
[28]黄华.电话回访式健康教育在心脏介入手术患者中的应用.实用心脑肺血管病杂志2006年5月第14卷第5期:415.
[29]赵菲,胡淑芬,吴焰.冠心病介入治疗康复现状.护理研究,2006年4月第20卷第4期下旬版(总第176期):1038-1039
[30] Goble AJ, Worcester MUC. Best Practice Guidelines for Cardiac Rehabilitation and Secondary Prevention. Melbourne Victoria, Australia: Heart Research Centre, Department of Human Services; 1999.
[31] Long-term Behavioral Outcomes After Attendance at a Secondary Prevention Clinic for Cardiac Patients Journal of Cardiopulmonary Rehabilitation (C) 2003 Lippincott Williams & Wilkins, Inc.Volume 23(6), November/December 2003, pp 415-422
[2] Mathers C, Bernard C, Iburg K, et al. Global Burden of Disease in 2002: Data Sources, Methods and Results. GPE Discussion Paper No. 54. Geneva: World Health Organization; 2004.
[3] Tod AM, Lacey EA, McNeill F. 'I'm still waiting[horizontal ellipsis]:barriers to accessing cardiac rehabilitation services. J Adv Nurs. 2002;40:421-431.
[4] Cannon RO 3rd. Restenosis after angioplasty. N Engl J Med. 2002;346:1182-1183. Bibliographic Links Document Delivery Library Holdings.
[5] Higgins, Rosemary O. Expressed preferences for health education of patients after percutaneous coronary intervention. European Journal of Cardiovascular Prevention(C) 2005 European Society of Cardiology, Volume 12(6), December 2005, pp 572-579
[6]胡大一.心脏病人精神卫生培训教程.人民军医出版社:117
[7] Lisspers J, Sundin O, Ohman A, Hofman-Bang C, Ryden L, Nygren A. Long-term effects of lifestyle behavior change in coronary artery disease: effects on recurrent coronary events after percutaneous coronary intervention. Health Psychol. 2005;24:41-48.
[8]黄悦勤主编,李立明主审。临床流行病学,人民卫生出版社:67
[9]于全俊,王苏中,等。冠心病防治指南。人民卫生出版社,2003:3~5
[10] Sullivan MD, LaCroix AZ, Spertus JA, Hecht J, Russo J. Depression predicts revascularization procedures for 5 years after coronary angiography. Psychosom Med. 2003;65:229-236. Ovid Full Text Bibliographic Links Document Delivery Library Holdings
[11] Worcester M, Mee V, Murphy B, Roberts S, Goble A. Cardiac rehabilitation programs: predictors of non-attendance and drop-out. Eur J Cardiovasc Prev Rehabil 2004; 11:328-335.
[12] Fernandez, Ritin S. Persistence of Coronary Risk Factor Status in Participants 12 to 18 Months After Percutaneous Coronary Intervention. The Journal of Cardiovascular Nursing(C) 2006 Lippincott Williams & Wilkins, Inc. Volume 21(5), September/October 2006, pp 379-387
[13] 2007 Writing Group. 2007 Focused Update of the ACC/AHA/SCAI 2005 Guideline Update for Percutaneous Coronary Intervention: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines
[14] Samaha, Frederick F. New International Measuring Stick for Defining Obesity in Non-Europeans,Circulation,Issue:Volume 115(16), 24 April 2007, pp 2089-2090 Publisher:(C) 2007 American Heart Association, Inc.
[15] Mittag, Oskara; Outcomes of cardiac rehabilitation with versus without a follow-up intervention rendered by telephone (Luebeck follow-up trial): overall and gender-specific effects[Original articles] International Journal of Rehabilitation Research(C) 2006 Lippincott Williams & Wilkins, Inc. Volume 29(4), December 2006, pp 295-302
[16] Lisspers, Jan Long-Term Effects of Lifestyle Behavior Change in Coronary Artery Disease: Effects on Recurrent Coronary Events After Percutaneous Coronary Intervention.[Article] Health Psychology, January 2005.24(1):41-48
[17] Vale, Margarite J. Impact of Coaching Patients on Coronary Risk Factors: Lessons from The COACH Program.[Review] Disease Management & Health Outcomes. 13(4):225-244, 2005.
[18] Cobb, Stephanie L. Effective interventions for lifestyle change after myocardial infarction or coronary artery revascularization.[Review] Journal of the American Academy of Nurse Practitioners.18(1):31-39, January 2006.
[19] Erbs, Sandra.Effects of exercise training on mortality in patients with coronary heart disease Coronary Artery Disease(C) 2006 Lippincott Williams & Wilkins, Inc. Volume 17(3), May 2006, pp 219-225
[20] Lip, G YH 1 Ethnicity and cardiovascular disease prevention in the United Kingdom: a practical approach to management.[Review] Journal of Human Hypertension. 21(3):183-211, March 2007.
[21] Guiducci, Umberto What to suggest after coronary angioplasty or bypass surgery procedures: a sedentary lifestyle, moderate physical activity or sports activity? [Controversial and emerging problems in sports cardiology] Journal of Cardiovascular Medicine (C) 2006 Italian Federation of CardiologyVolume 7(4), April 2006, p 296-300
[22] Parkosewich, Janet A. Cardiac Rehabilitation Barriers and Opportunities Among Women With Cardiovascular Disease[Review Article] Cardiology in Review (C) 2008 Lippincott Williams & Wilkins, Inc.Volume 16(1), January/February 2008, pp 36-52
[23] Watson, Karol MD. Managing Cardiometabolic Risk: An Evolving Approach to Patient Care[Original Article] Critical Pathways in Cardiology: A Journal of Evidence-Based Medicine (C) 2007 Lippincott Williams & Wilkins, Inc.Volume 6(1), March 2007, pp 5-14
[24]赵菲,邝碧娟,曾丽吟,.冠心病二级预防中干预模式的应用研究,护理学杂志2004年8月第19卷第15期(综合版):7-10
[25]郭兰.冠心病人的心脏康复治疗和生命网.中国医药导刊,2004年第6卷第5期(总第34期):389-390
[26]邝碧娟,赵菲,曾丽吟,王湘郴,包世敏。健康教育在冠心病二级预防中的作用.现代护理,2006年第12卷第16期:1551-1552
[27]刘永平,郑兴。康复锻炼对冠心病二级预防的作用。中国老年医学杂志2007年2月第27卷:398-400
[28]刘义富,冯雪梅.康复治疗对冠心病介入治疗疗效的影响.医师进修杂志2005年4月第28卷第4期内科版:38-39
[29]黄华.电话回访式健康教育在心脏介入手术患者中的应用.实用心脑肺血管病杂志2006年5月第14卷第5期:415.
[30]赵菲,胡淑芬,吴焰.冠心病介入治疗康复现状.护理研究,2006年4月第20卷第4期下旬版(总第176期):1038-1039
[31] Worcester, Marian Una Christine PhD, MA, BA; Stojcevski, Zlatko MEd Psych, BSc,Grad Dip App Psych: Long-term Behavioral Outcomes After Attendance at a Secondary Prevention Clinic for Cardiac Patients, Journal of Cardiopulmonary Rehabilitation(C) 2003 Lippincott Williams & Wilkins, Inc. Volume 23(6), November/December 2003, pp 415-422
[32] Correspondence and requests for reprints to Jan Erik Otterstad, MD, FESC, Influence on lifestyle measures and five-year coronary risk by a comprehensivelifestyle intervention p rogramme in patients with coronary heart disease, European Journal of Cardiovascular Prevention & Rehabilitation (C) 2003 European Society of Cardiology,Volume 10(6), December 2003, pp 429-437
[33] Goble AJ, Worcester MUC. Best Practice Guidelines for Cardiac Rehabilitation and Secondary Prevention. Melbourne Victoria, Australia: Heart Research Centre, Department of Human Services; 1999.
[34] Long-term Behavioral Outcomes After Attendance at a Secondary Prevention Clinic for Cardiac Patients Journal of Cardiopulmonary Rehabilitation (C) 2003 Lippincott Williams & Wilkins, Inc.Volume 23(6), November/December 2003, pp 415-422
[35]魏本领,冠心病患者康复期安全运动耐量的评估.海军医学杂志2004年9月第25卷第3期:223~224
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[2] Tod AM, Lacey EA, McNeill F. 'I'm still waiting[horizontal ellipsis]:barriers to accessing cardiac rehabilitation services. J Adv Nurs. 2002;40:421-431.
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[6]张光明,魏承承毓.预防冠心病相关因素的研究进展.国外医学·社会医学分册,2002年3月第19卷第1期:32-35
[7] Edwards R. The problem of tobacco smoking. Br Med J. 2004;328:217-219. Ovid Full Text Bibliographic Links Document Delivery Library Holdings
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[9]王宏宇,胡大一.冠心病二级预防策略.中国医刊,2003年第38卷第7期(总445):61-62.
[10] Sullivan MD, LaCroix AZ, Spertus JA, Hecht J, Russo J. Depression predicts revascularization procedures for 5 years after coronary angiography. Psychosom Med. 2003;65:229-236. Ovid Full Text Bibliographic Links Document Delivery Library Holdings
[11] 2007 Writing Group. 2007 Focused Update of the ACC/AHA/SCAI 2005 Guideline Update for Percutaneous Coronary Intervention: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines [PCI Focused Update] Circulation(C) 2008 American Heart Association, Inc. Volume 117(2), 15 January 2008, pp 261-295
[12] Fernandez, Ritin S. Persistence of Coronary Risk Factor Status in Participants 12 to 18 Months After Percutaneous Coronary Intervention. The Journal of Cardiovascular Nursing(C) 2006 Lippincott Williams & Wilkins, Inc. Volume 21(5), September/October 2006, pp 379-387
[13] Worcester M, Mee V, Murphy B, Roberts S, Goble A. Cardiac rehabilitation programs: predictors of non-attendance and drop-out. Eur J Cardiovasc Prev Rehabil 2004; 11:328-335.
[14] Mittag, Oskara; Outcomes of cardiac rehabilitation with versus without a follow-upintervention rendered by telephone (Luebeck follow-up trial): overall and gender-specific effects[Original articles] International Journal of Rehabilitation Research(C) 2006 Lippincott Williams & Wilkins, Inc. Volume 29(4), December 2006, pp 295-302
[15] Lisspers, Jan Long-Term Effects of Lifestyle Behavior Change in Coronary Artery Disease: Effects on Recurrent Coronary Events After Percutaneous Coronary Intervention.[Article] Health Psychology, January 2005.24(1):41-48
[16] Vale, Margarite J. Impact of Coaching Patients on Coronary Risk Factors: Lessons from The COACH Program.[Review] Disease Management & Health Outcomes. 13(4):225-244, 2005.
[17] Cobb, Stephanie L. Effective interventions for lifestyle change after myocardial infarction or coronary artery revascularization.[Review] Journal of the American Academy of Nurse Practitioners.18(1):31-39, January 2006.
[18] Erbs, Sandra.Effects of exercise training on mortality in patients with coronary heart disease Coronary Artery Disease(C) 2006 Lippincott Williams & Wilkins, Inc. Volume 17(3), May 2006, pp 219-225
[19] Lip, G YH 1 Ethnicity and cardiovascular disease prevention in the United Kingdom: a practical approach to management.[Review] Journal of Human Hypertension. 21(3):183-211, March 2007.
[20] Guiducci, Umberto What to suggest after coronary angioplasty or bypass surgery procedures: a sedentary lifestyle, moderate physical activity or sports activity? [Controversial and emerging problems in sports cardiology] Journal of Cardiovascular Medicine (C) 2006 Italian Federation of CardiologyVolume 7(4), April 2006, p 296-300
[21] Parkosewich, Janet A. Cardiac Rehabilitation Barriers and Opportunities Among Women With Cardiovascular Disease[Review Article] Cardiology in Review (C) 2008 Lippincott Williams & Wilkins, Inc.Volume 16(1), January/February 2008, pp 36-52
[22] Watson, Karol MD. Managing Cardiometabolic Risk: An Evolving Approach to Patient Care[Original Article] Critical Pathways in Cardiology: A Journal of Evidence-Based Medicine (C) 2007 Lippincott Williams & Wilkins, Inc.Volume 6(1), March 2007, pp 5-14
[23]赵菲,邝碧娟,曾丽吟,.冠心病二级预防中干预模式的应用研究,护理学杂志2004年8月第19卷第15期(综合版):7-10
[24]郭兰.冠心病人的心脏康复治疗和生命网.中国医药导刊,2004年第6卷第5期(总第34期):389-390
[25]邝碧娟,赵菲,曾丽吟,王湘郴,包世敏。健康教育在冠心病二级预防中的作用.现代护理,2006年第12卷第16期:1551-1552
[26]刘永平,郑兴。康复锻炼对冠心病二级预防的作用。中国老年医学杂志2007年2月第27卷:398-400
[27]刘义富,冯雪梅.康复治疗对冠心病介入治疗疗效的影响.医师进修杂志2005年4月第28卷第4期内科版:38-39
[28]黄华.电话回访式健康教育在心脏介入手术患者中的应用.实用心脑肺血管病杂志2006年5月第14卷第5期:415.
[29]赵菲,胡淑芬,吴焰.冠心病介入治疗康复现状.护理研究,2006年4月第20卷第4期下旬版(总第176期):1038-1039
[30] Goble AJ, Worcester MUC. Best Practice Guidelines for Cardiac Rehabilitation and Secondary Prevention. Melbourne Victoria, Australia: Heart Research Centre, Department of Human Services; 1999.
[31] Long-term Behavioral Outcomes After Attendance at a Secondary Prevention Clinic for Cardiac Patients Journal of Cardiopulmonary Rehabilitation (C) 2003 Lippincott Williams & Wilkins, Inc.Volume 23(6), November/December 2003, pp 415-422