A controlled trial of a nurse follow-up dietary intervention on maintaining a heart-healthy dietary pattern among patients after myocardial infarction

Auteur(s) :
Mok VK., Sit JW., Tsang AS.
Date :
Avr, 2012
Source(s) :
J CARDIOVASC NURS. # p
Adresse :
Vincent K. F. Mok, APN, MScN Registered Nurse, Department of Medicine, Queen Elizabeth Hospital, Kowloon, Hong Kong SAR, China. Janet W. H. Sit, PhD, RN Associate Professor, Nethersole School of Nursing, Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR, China. Alice S. M. Tsang, PhD, RN Assistant Professor, School of Nursing, Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR, China. Sek Ying Chair, PhD, RN Associate Professor, Nethersole School of Nursing, Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR, China. Tak Lai Cheng, APN Advanced Practice Nurse, Department of Medicine, Cardiac Care Unit, Queen Elizabeth Hospital, Kowloon, Hong Kong SAR, China. Chung-seung Chiang, MBBS, MRCP, FHKCP, FHKAM, FRCP Consultant, Department of Medicine, Queen Elizabeth Hospital, Kowloon, Hong Kong SAR, China

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BACKGROUND AND RESEARCH OBJECTIVE:
Post-myocardial infarction (MI) survivors are at a higher risk of coronary events. Therapeutic lifestyle changes, including dietary modification, have been emphasized as the cornerstone of secondary prevention. This study aimed to examine the effectiveness of a nurse follow-up dietary intervention (NFDI) on post-MI patients' dietary behavioral change (primary outcome) and blood lipid levels (secondary outcome).

SUBJECTS AND METHODS:
A total of 82 post-MI subjects with borderline dyslipidemia were recruited and randomly allocated to a control group or an intervention group (IG) (n = 41/group). The control group received conventional care and attended a heart health dietary class. The IG received, in addition, a structured 8-week NFDI (including a face-to-face consultation session, a take-home self-management workbook, and fortnightly telephone follow-ups). Data were collected at 3 time points: baseline (T0), 1-week posttest (T1), 3-month posttest (T2). The effect of the intervention was assessed by a self-report questionnaire and blood tests. T test and time-by-group analysis of variance with repeated-measures analysis of variance were used. An intention-to-treat analysis was conducted.

RESULTS:
Significant positive dietary changes were found among participants of the IG in reduced intake of saturated fat (F = 22.48, P < .001) and salted/preserved food (F = 13.58, P < .001) and increased intake of heart-healthy food (vegetables, fruit, nuts, and whole grains) (F = 40.88, P < .001). Although the results of secondary outcomes, triglyceride, and total cholesterol were not statistically significant, the high-density lipoprotein trend was in the expected direction for the IG (F = 8.982, P = .001).

CONCLUSION:
This study found positive changes in dietary behavior and an increase in high-density lipoprotein level from participants who undertook the NFDI for self-management in dietary modification.

Source : Pubmed
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