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一项基于网络的定制护理干预(TAVIE en m @ rche),其旨在增加急性冠状动脉综合征后的行走:多中心随机研究
Author(s) -
Kayser John William,
Cossette Sylvie,
Côté José,
Tanguay JeanFrancois,
Tremblay JeanFrancois,
Diodati Jean Gino,
Bourbonnais Anne,
Purden Margaret,
Juneau Martin,
Terrier Julien,
Dupuis Jocelyn,
MaheuCadotte MarcAndré,
Fontaine Guillaume,
Cournoyer Daniel
Publication year - 2019
Publication title -
journal of advanced nursing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.948
H-Index - 155
eISSN - 1365-2648
pISSN - 0309-2402
DOI - 10.1111/jan.14119
Subject(s) - medicine , acute coronary syndrome , randomized controlled trial , attendance , physical therapy , emergency department , nursing , myocardial infarction , economics , economic growth
Aim Evaluate a web‐based tailored nursing intervention, TAVIE en m@rche, on increasing daily steps after an acute coronary syndrome. Design Parallel two‐group multicentre randomized trial. Methods An experimental group receiving TAVIE en m@rche, was compared to a control group receiving hyperlinks to public websites. Acute coronary syndrome patients who were insufficiently active were recruited from three coronary care units. Daily steps at 12 weeks were the primary outcome. Secondary outcomes included self‐reported walking and moderate to vigorous physical activity (MVPA). Exploratory outcomes were angina frequency, emergency department visits, hospitalizations and secondary prevention programme attendance. Results Primary data were analysed for 39 participants. No significant effects were found. At 12 weeks 275.9 more daily steps and 1,464.3 more energy expenditure in MVPA were found in the experimental group relative to the control. No effects were found for angina frequency, emergency department visits, hospitalizations and secondary prevention programme attendance. Conclusion The lack of effect on our primary result may be explained by the intervention goal that was mismatched to the needs of our mostly sufficiently active sample at randomization, resulting in no meaningful change in daily steps. Although the non‐significantly greater increase in self‐reported MVPA may represent gains in health among the participants that accessed TAVIE en m@rche, this result should be interpreted with caution. Impact From 40%‐60% of acute coronary syndrome patients self‐report insufficient levels of physical activity. No effect was found on the primary outcome of daily steps. Although not significant, a greater increase in MVPA was found at 12 weeks. The primary outcome can be explained by most of the sample having attained the physical activity recommendation at randomization. Caution in interpreting the non‐significant increase in MVPA is warranted due to attrition bias and statistical uncertainty. Future directions may consider the timing of randomization in relation to meeting the needs of insufficiently active acute coronary syndrome patients.