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首页> 外文期刊>Journal of advanced nursing >A realist study of the mechanisms of cardiac rehabilitation.
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A realist study of the mechanisms of cardiac rehabilitation.

机译：心脏康复机制的现实研究。

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AIM: The aim of this paper is to report patients' experiences of cardiac rehabilitation and perceptions of the mechanisms and contexts influencing its long-term effectiveness. BACKGROUND: Cardiac rehabilitation programmes for the secondary prevention of coronary heart disease are common. The effects of these programmes, however, can be inconsistent and little is known of the personal and contextual factors that influence service effectiveness. METHOD: Forty-seven participants with a formal diagnosis of coronary heart disease who had attended a programme of cardiac rehabilitation in Scotland 3 years previously were included in focus groups to discuss their perceptions and experiences (30 males and 17 females). The data were generated in 2002 and analysed using the realist approach of Pawson and Tilley (1997). RESULTS: Participants' accounts indicated that the didactic content of cardiac rehabilitation was not strongly linked to longer-term health behaviour change. The main positive effects of cardiac rehabilitation were related to the effect of participation on mediating social and body-focused mechanisms that were triggered when the rehabilitation setting was perceived to be safe. Social mechanisms identified included social comparisons, camaraderie, and social capital. Body-focused mechanisms included greater knowledge of personal physical boundaries and a greater trust in the heart-diseased body. Collectively, these mechanisms had a positive effect on confidence that was perceived as being imperative to maintain health behaviour change. CONCLUSIONS: More support is required to promote health behaviour change after the completion of cardiac rehabilitation. Use of community-based exercise services and conventional or web-based support groups for coronary heart disease patients should be encouraged, as these appear to extend the positive health effects of the mechanisms that promote behaviour change. At the completion of cardiac rehabilitation programmes, patients should be referred to safe and appropriate community-based exercise services. Further research is needed to examine the effects on health outcomes of mechanisms and contexts related to cardiac rehabilitation.
机译：目的：本文的目的是报告患者的心脏康复经验以及对影响其长期有效性的机制和背景的看法。背景：用于冠心病二级预防的心脏康复计划很普遍。但是，这些计划的效果可能会不一致，并且对影响服务有效性的个人和背景因素知之甚少。方法：37年前参加苏格兰心脏康复计划的47位正式诊断为冠心病的参与者被纳入焦点小组，讨论他们的看法和经验（男性30例，女性17例）。数据产生于2002年，并使用Pawson和Tilley（1997）的现实主义方法进行了分析。结果：参加者的陈述表明，心脏康复的教学内容与长期健康行为改变没有密切关系。心脏康复的主要积极作用与参与对调解社会和身体相关机制的影响有关，这些机制是在康复环境被认为是安全的情况下触发的。确定的社会机制包括社会比较，友爱和社会资本。以身体为中心的机制包括对个人身体界限的更多了解以及对心脏疾病患者身体的信任。总的来说，这些机制对人们的信心产生了积极影响，人们认为这种信心对于保持健康行为的改变至关重要。结论：完成心脏康复后，需要更多的支持来促进健康行为的改变。应鼓励为冠心病患者使用基于社区的运动服务和常规或基于网络的支持组，因为这些服务似乎可以扩大促进行为改变的机制对健康的积极影响。在完成心脏康复计划后，应为患者提供安全，适当的社区锻炼服务。需要进行进一步的研究以检查与心脏康复有关的机制和环境对健康结果的影响。

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