Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 4 de 4
Filtrar
1.
Neth Heart J ; 32(1): 38-44, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37945935

RESUMO

OBJECTIVE: Communicating risk information and offering lifestyle advice are important goals in cardiac rehabilitation. However, the most effective way and the most effective source to communicate this information are not yet known. Therefore, we examined the effect of source (cardiologist, physiotherapist) and framing (gain, loss) of brief lifestyle advice on patients' intention-to-change-lifestyle. METHODS: In an online experimental study, 636 cardiac patients (40% female, 67 (10) yrs.) were randomly assigned to one of four textual vignettes. Effect of source and framing on intention-to-change-lifestyle (assessed using a 5-point Likert scale) was analysed using analysis of covariance (ANCOVA). RESULTS: Patients expressed positive intention-to-change-lifestyle after receiving advice from the cardiologist (M = 4.1) and physiotherapist (M = 3.9). However, patients showed significantly higher intention-to-change-lifestyle after receiving advice from the cardiologist (0.58 [0.54-0.61]) when compared with the physiotherapist (0.52 [0.48-0.56]), (F[1,609] = 7.06, P = 0.01). Gain-framed and loss-framed advice appeared equally effective. However, communicating risks (loss) was remembered by only 9% of patients, whereas 89% remembered benefits (gain). CONCLUSIONS: Our study shows the value of cardiologists and physiotherapists communicating brief lifestyle advice, as cardiac patients expressed positive intention for lifestyle change after receiving advice, irrespective of framing. Lifestyle advice should include benefits due to better recall.

2.
PEC Innov ; 1: 100071, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37213735

RESUMO

Background: Lifestyle support is essential in preventing and treating cardiovascular diseases (CVD), and eHealth may be an easy and affordable solution to provide this support. However, CVD patients vary in their ability and interest to use eHealth. This study investigates demographic characteristics determining CVD patients' online and offline lifestyle support preferences. Methods: We used a cross-sectional study design. 659 CVD patients (Harteraad panel) completed our questionnaire. We assessed demographic characteristics and preferred lifestyle support type (coach, eHealth, family/friends, self-supportive). Results: Respondents mostly preferred being self-supportive (n = 179, 27.2%), and a coach in a group or individually (n = 145, 22.0%; n = 139, 21.1%). An app/internet to work independently (n = 89, 13.5%) or being in touch with other CVD patients (n = 44, 6.7%) was least preferred. Men were more likely to prefer being supported by family/friends (p = .016) or self-supportive (p < .001), while women preferred a coach individually or via an app/internet (p < .001). Older patients mostly preferred self-support (p = .001). Patients with low social support were more likely to prefer being coached individually (p < .001), but not support from family/friends (p = .002). Conclusion: Men and older patients are more interested in being self-supportive, and patients with lower levels of social support could need extra support outside their social network. eHealth could provide a solution, but attention should be paid to spike interest for digital interventions among certain groups.

3.
Artigo em Inglês | MEDLINE | ID: mdl-28228452

RESUMO

BACKGROUND: A Dutch online patient decision aid to support prosthetic heart valve selection was recently developed. A multicenter randomized controlled trial was conducted to assess whether use of the patient decision aid results in optimization of shared decision making in prosthetic heart valve selection. METHODS AND RESULTS: In a 5-center randomized controlled trial, patients were allocated to receive either standard preoperative care (control group) or additional access to the patient decision aid (intervention group). Legally capable adult patients accepted for elective isolated or combined aortic and mitral valve replacement were included. Primary outcome was preoperative decisional conflict (Decisional Conflict Scale); secondary outcomes included patient knowledge, involvement in valve selection, anxiety and depression, (valve-specific) quality of life, and regret. Out of 306 eligible patients, 155 were randomized (78 control and 77 intervention). Preoperative decisional conflict did not differ between the groups (34% versus 33%; P=0.834). Intervention patients felt better informed (median Decisional Conflict Scale informed subscore: 8 versus 17; P=0.046) and had a better knowledge of prosthetic valves (85% versus 68%; P=0.004). Intervention patients experienced less anxiety and depression (median Hospital Anxiety and Depression Scale score: 6 versus 9; P=0.015) and better mental well-being (mean Short Form Health Survey score: 54 versus 50; P=0.032). Three months postoperatively, valve-specific quality of life and regret did not differ between the groups. CONCLUSIONS: A patient decision aid to support shared decision making in prosthetic heart valve selection does not lower decisional conflict. It does result in more knowledgeable, better informed, and less anxious and depressed patients, with a better mental well-being. CLINICAL TRIAL REGISTRATION: http://www.trialregister.nl. Unique identifier: NTR4350.


Assuntos
Valva Aórtica/cirurgia , Tomada de Decisão Clínica , Técnicas de Apoio para a Decisão , Doenças das Valvas Cardíacas/cirurgia , Implante de Prótese de Valva Cardíaca/instrumentação , Próteses Valvulares Cardíacas , Valva Mitral/cirurgia , Seleção de Pacientes , Desenho de Prótese , Adulto , Idoso , Idoso de 80 Anos ou mais , Ansiedade/etiologia , Ansiedade/prevenção & controle , Valva Aórtica/fisiopatologia , Depressão/etiologia , Depressão/prevenção & controle , Feminino , Doenças das Valvas Cardíacas/diagnóstico , Doenças das Valvas Cardíacas/fisiopatologia , Implante de Prótese de Valva Cardíaca/efeitos adversos , Humanos , Internet , Masculino , Saúde Mental , Pessoa de Meia-Idade , Valva Mitral/fisiopatologia , Países Baixos , Educação de Pacientes como Assunto , Satisfação do Paciente , Valor Preditivo dos Testes , Estudos Prospectivos , Qualidade de Vida , Medição de Risco , Fatores de Risco , Inquéritos e Questionários , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
4.
Int J Med Inform ; 82(12): 1183-94, 2013 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-24113277

RESUMO

OBJECTIVE: Web-based self-management services remain underutilized in current practice. Our aim was to gain insight into disease and self-management experiences of patients in early and progressive stages of coronary heart disease (CHD), to understand moderating effects of daily life experiences on the utilization of web-based self-management services and preconditions for use. METHODS: We applied generative research techniques, which stem from the field of product design and are characterized by the use of creative processes. Three groups of patients with CHD received a sensitizing package to document and reflect on their health, and were subsequently either interviewed or participated in a focus group session. RESULTS: In total, 23 patients participated in this study. Emerging themes were (1) fear for recurrent events, (2) experiences with professional care, (3) the perceived inability to prevent disease progression, (4) the desire to go on living without thinking about the disease every day, (5) the social environment as a barrier to or facilitator for self-management, and (6) the need for information tailored to personal preferences. CONCLUSION: How patients experience their disease varies between stable and post-acute stages, as well as between early and progressive stages of CHD. Patients in post-acute stages of the disease seem to be most amenable to support, while patients in stable stages want to live their life without being reminded of their disease. In the context of self-management, web-based services should be adapted to the variation in needs that occur in the different stages of CHD and new strategies to fit such services to these needs should be developed. Furthermore, they should be tailored to patients' individual health situation and preferences, support patient empowerment, and manage expectations regarding the progression of their disease.


Assuntos
Doença das Coronárias/psicologia , Grupos Focais/estatística & dados numéricos , Internet/estatística & dados numéricos , Participação do Paciente , Autocuidado/psicologia , Idoso , Doença das Coronárias/terapia , Gerenciamento Clínico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Avaliação das Necessidades , Pesquisa Qualitativa , Apoio Social
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA