- Volume 28 Issue 2
DOI QR Code
A Pilot Study of APN-led Self-management Program to Improve Cardiovascular Health Status among Korean Women with Risk Factors
- Received : 2016.03.16
- Accepted : 2016.04.18
- Published : 2016.04.30
Purpose: The aim of this study was to examine the effects of an Advanced Practice Nurse (APN)-led self-management program on cardiovascular health status among Korean women at risk of developing or progressing cardiovascular disease. Methods: This pilot study used one-group pre- and post- test experimental design. At health fairs in a community, 30 women who had one or more risk factors for metabolic syndrome were recruited and agreed to participate in the study. A total of 25 women completed the study. The intervention consisted of weekly follow-up calls and self-monitoring diary after an hour of individual counseling regarding risk factors, fast walking, and healthy diet tailored to the participants' needs. Physical activity was assessed with the World Health Organization International Physical Activity Questionnaire and a pedometer. Results: Participants showed statistically significant improvements in blood pressure, body mass index, levels of triglyceride, total cholesterol and low density lipoprotein, numbers of metabolic syndrome factors, and the 10-year CV risk estimate after one month of concentrated intervention. In addition, their physical activity behavior significantly improved after the intervention. Conclusion: This APN-led self-management program targeting modifiable risk factors by offering tailored counseling and concentrated support during the transition might be effective in preventing progression to the cardiovascular disease.
Cardiovascular disease;Diet;Physical activity;APN;Metabolic syndrome
- Korea National Statistical Office. 2008 Annual Report for the Cause of Mortality [Internet] Seoul: [cited 2010 April, 4]. Available from: http://kosis.kr/statHtml/statHtml.do?orgId=101&tblId=DT_1B34E02&vw_cd=&list_id=&scrId=&seqNo=&lang_mode=ko&obj_var_id=&itm_id=&conn_path=K1&path=.
- American Heart Association (2013). Special report-fifteen-year trends in awareness of heart disease in women: results of a 2012 American Heart Association National Survey. http://dx.doi.org/10.1161/CIR.0b013e318287cf2f
- United Nations Population Fund. State of World Population 2012 [Internet]. New York: United Nations Population Fund; 2012 [cited 2014 June, 25]. Available from: http://www.unfpa.org/sites/default/files/pub-pdf/EN_SWOP2012_Report.pdf
- Shen. B. Top ten impediments to better health & health care in the United States [Internet]. California: Institute for the Future; 2005 [cited 2011 May, 18]. Available from: http://www.iftf.org/uploads/media/SR-900_Top_Ten_Impediments.pdf
- Ebrahim S, Beswick A, Burke M, Smith GD. Multiple risk factor interventions for primary prevention of coronary heart disease. Cochrane Database of Systemic Reviews 2006 4: CD001561
- Cronenwett L, Sherwood G, Pohl J, Barnsteiner J, Moore S, Sullivan DT, et al. Quality and safety education for advanced nursing practice. Nurse Outlook. 200957:338-48. http://dx.doi.org/10.1016/j.outlook.2009.07.009 https://doi.org/10.1016/j.outlook.2009.07.009
- Trost SG, Owen N, Bauman AE, Sallis JF, Brown W. Correlates of adults' participation in physical activity: review and update. Medicine and Science in Sports and Exercise. 2002;34(12):1996-2001. https://doi.org/10.1097/00005768-200212000-00020
- Ahn S. Effects of walking on cardiovascular risk factors and psychosocial outcomes in postmenopausal obese women. Journal of Korean Academy of Nursing. 2007;37:519-28. https://doi.org/10.4040/jkan.2007.37.4.519
- Park NH. Effects of lifestyle modification program on body composition, metabolicsyndrome markers, and depression in obese postmenopausal women. Journal of Korean Public Health Nursing. 2013;27(2):313-26. http://dx.doi.org/10.5932/JKPHN.2013.27.2.313 https://doi.org/10.5932/JKPHN.2013.27.2.313
- Heo YH, Kim EJ, Seo HS, Kim SM, Choi KM, Hwang TG, et al. The effect of 16 week exercise program on abdominal fat, serum lipids, blood glucose, and blood pressure in obese women. Korean Journal of Obesity. 2010;19:16-23.
- Lee YW, Lee, JH. Effects of 12 weeks of sports dance on cardiovascular risk factors in abdominally obese middle-aged women. Korean Journal of Obesity. 2007;16:16-22.
- Song R, Ahn S, So H, Park I, Kim H, Joo K, et al. Effects of Tai Chi exercise on cardiovascular risk factors and quality of life in post-menopausal women. Journal of Korean Academy of Nursing. 2009;39:136-44. https://doi.org/10.4040/jkan.2009.39.1.136
- Kim H, June K, Song R. Effects of nutrition education and exercise programs on perceived dietary behaviors, food intake and serum lipid profiles in elderly Korean women living in residential homes. Asian Nursing Research. 2007;1:35-47. https://doi.org/10.1016/S1976-1317(08)60007-9
- Lee G, Choi H, Yang S. Effects of dietary and physical activity interventions on metabolic syndrome: a meta-analysis. Journal of Korean Academy of Nursing. 2015;45:484-94. http://dx.doi.org/10.4040/jkan.2015.45.4.483
- Craig CL, Marshall AL, Sjostrom M, Bauman AE, Booth ML, Ainsworth BE, et al. International physical activity questionnaire: 12-country reliability and validity. Medicine and Science in Sports and Exercise. 2003;35:1381-95. https://doi.org/10.1249/01.MSS.0000078924.61453.FB
- Kristal AR, Shattuck AL, Henry HJ. Patterns of dietary behavior associated with selecting diets low in fat: reliability and validity of a behavioral approach to dietary assessment. Journal of the American Dietetic Association. 1990;90:214-20.
- National Hypertension Center. Diet modification [Internet]. Seoul: National Hypertension Center; 2009 [cited 2009 May, 15]. Available from: http://www.hypertension.or.kr/viewC.php?vCode=305001&main_num=3&sub_num=5&sub_num=2=1
- Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL, et al. National high blood pressure education program: the seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure. U. S. Department of Health & Human Services: National Institutes of Health Publication No. 04-5230 2004.
- Lee S, Park H, Kim S, Kwon H, Kim D, Kim D, et al. Cut-off points of waist circumference for defining abdominal obesity in the Korean population. Korean Journal of Obesity. 2006;15:1-9.
- Grundy SM. Metabolic syndrome scientific statement by the American Heart Association and the National Heart, Lung, & Blood institute. Arteriosclerosis, Thrombosis, & Vascular Biology. 2005;25:2243-4. http://dx.doi.org/10.1161/01.ATV.0000189155.75833.c7 https://doi.org/10.1161/01.ATV.0000189155.75833.c7
- Park YJ, Shin NM, Yoon JW, Choi JW, Lee SJ. Comparison of cardiovascular health status and health behaviors in Korean women based on household income. Journal of Korean Academy of Nursing. 2010;40(6):831-43. http://dx.doi.org/10.4040/jkan.2010.40.6.831 https://doi.org/10.4040/jkan.2010.40.6.831
- Moore TJ, Svetkey L, Appel L, Bray G, Vollmer W. The DASH diet for hypertension. 2001. New York: Simon & Schuster.
- Hanssen TA, Nordrehaug JE, Eide GE, Hanestad BR. Improving outcomes after myocardial infarction: a randomized controlled trial evaluating effects of a telephone follow-up intervention. European Journal of Cardiovascular Preventive Rehabilitation. 2007;14:429-37. http://dx.doi.org/10.1097/HJR.0b013e32801da123 https://doi.org/10.1097/HJR.0b013e32801da123
- Agency for Healthcare Research and Quality(AHRQ). The number of nurse practitioners and physician assistants practicing primary care in the United States. Primary Care Workforce Facts and StatsNo.2. [Internet]. U. S., 2011 [cited 2016 April, 5]. Available from http://www.ahrq.gov/research/findings/factsheets/primary/pcwork2/index.html
- Hart AM. The advanced practice registered nurse in chronic illness care. In: Larsen PD, editor. Lubkin's chronic illness impact and intervention. 9thed. Burlington, MA: Jones & Bartlett Learning; 2016. p. 397-424.
- Kim T, Juon H, Hill M, Post W, Kim K. Cardiovascular disease risk factors in Korean American elderly. Western Journal of Nursing Research. 2001;23(3):269-82. http://dx.doi.org/10.1177/01939450122045140 https://doi.org/10.1177/01939450122045140
- Ministry of Health & Welfare. 2010 National health and nutrition survey [Internet]. Seoul, 2011 [cited 2013 September, 19]. Available from http://knhanes.cdc.go.kr/
- Kim S, Sohn C, Chung WY. Effects of medical nutrition therapy on food habits and serum lipid levels of hypercholesterolemic patients. Journal of Korean Dietetic Association. 2005;11:125-32.
- Ju K, So H. Effects of the nutrition education program on self-efficacy, diet behavior pattern and cardiovascular risk factors for the patients with cardiovascular disease. Journal of Korean Academy of Nursing. 2008;38:64-73. https://doi.org/10.4040/jkan.2008.38.1.64
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Supported by : Korea Institute for Health & Social Affairs