Asian Nurs Res.  2017 Sep;11(3):187-193. 10.1016/j.anr.2017.07.004.

Examination of a Nurse-led Community-based Education and Coaching Intervention for Coronary Heart Disease High-risk Individuals in China

Affiliations
  • 1Department of Community Nursing, Xiangya Nursing School, Central South University, Changsha, PR China. hgpcsu512@126.com
  • 2Department of Nurse Practitioner Field of Study, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada.
  • 3Department of International and Humanistic Nursing, School of Nursing, University of South China, Hengyang, PR China.
  • 4Department of Surgical Nursing, School of Nursing, Xi'an Jiaotong University, Xi'an, PR China.
  • 5Department of Nursing, The Second Affiliated Hospital of University of South China, Hengyang, PR China.

Abstract

PURPOSE
Early detection and management of coronary heart disease (CHD) are embedded into many community health service and primary care practices in western countries. The Framingham CHD risk score has been used to predict CHD and mortality for nearly 20 years, and it has predicted CHD event risk accurately in multiethnic populations. The aim of this study was to access the effect of a 6-month community-based intervention on CHD risk in individuals at high risk.
METHODS
A randomized controlled trial of individuals with a high 10-year CHD risk were recruited from two communities in China. Individuals in the intervention group (n = 53) received a 3-month group education and a 3-month coaching session. Physical examination and self-report questionnaires were used to collect both pre- and postintervention data on blood pressure, glucose, cholesterol, body mass index, smoking, depression, and health-related quality of life (HRQoL).
RESULTS
A total of 102 participants (85.0%) completed the 6-month study. Compared with the usual care group, the intervention group had a 5 mmHg greater reduction in systolic blood pressure (t = 2.01, p = .047), larger declines in glucose (t = −2.49, p = .015), cholesterol (t = −2.44, p = .017), body mass index (t = −2.58, p = .011), and depression (t = −2.05, p = .043), and better reports of HRQoL (t = 3.36, p = .001). No significant group differences in smoking behaviors were reported.
CONCLUSION
A 6-month community-based intervention in a CHD high-risk population improved disease-related risk factors, depression, and HRQoL. Results provide preliminary evidence for primary prevention of cardiovascular disease risk in a community high-risk population.

Keyword

coronary heart disease; intervention study; primary prevention

MeSH Terms

Blood Pressure
Body Mass Index
Cardiovascular Diseases
China*
Cholesterol
Community Health Services
Coronary Disease*
Depression
Education*
Glucose
Mortality
Physical Examination
Primary Health Care
Primary Prevention
Quality of Life
Risk Factors
Smoke
Smoking
Cholesterol
Glucose
Smoke
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