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Wang X, Chen D, Zou P, Zhang H, Qiu X, Xu L, Lee G. Understanding adaptive tasks in cardiac rehabilitation among patients with acute myocardial infarction: a qualitative study. Ann Med 2024; 56:2311227. [PMID: 38306095 PMCID: PMC10840589 DOI: 10.1080/07853890.2024.2311227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 01/19/2024] [Indexed: 02/03/2024] Open
Abstract
BACKGROUND While Cardiac Rehabilitation (CR) programs have shown effectiveness in improving cardiac outcomes, there is limited understanding of how patients perceive and adapt to these interventions. Furthermore, alternative modes of delivering CR that have received positive evaluations from participants remain underexplored, yet they have the potential to enhance CR uptake. OBJECTIVES To explore the patient experience in CR programmes following Acute Myocardial Infarction (AMI) and describe their adaptive processing. PATIENTS AND METHODS This qualitative study was conducted at a nationally certified centre in China between July 2021 and September 2022, encompassing three stages: in-hospital, centre-based, and home-based CR programs. Purposive sampling was used to select eligible AMI patients for in-depth semi-structured interviews. The interview outline and analytical framework were aligned with the key concepts derived from the middle-range theory of adaptation to chronic illness and the normalization process theory. The findings were reported following the Consolidated Criteria for Reporting Qualitative Research checklist. RESULTS Forty AMI patients were recruited. Four main themes describing the process of AMI patients normalizing CR intervention were identified, including (1) experiencing CR service driving by role's responsibilities, (2) engaging in collaborative relationship based on interpersonal trust, (3) exploring a personalized rehabilitation plan by complex integration, and (4) expecting a promised outcome to shape decision-making. CONCLUSION Integrated care interventions for AMI patients could benefit from a collaborative co-designed approach to ensure that CR interventions are normalized and fit into patients' daily lives. Organizational-level CR services should align with the rehabilitation needs and expectations of patients.
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Affiliation(s)
- Xiyi Wang
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Dandan Chen
- School of Nursing, Zhejiang University School of Medicine, Zhejiang, China
| | - Ping Zou
- School of Nursing, Nipissing University, Toronto, Ontario, Canada
| | - Hui Zhang
- Department of Cardiology, Guizhou Provincial People’s Hospital, Guizhou, China
| | - Xunhan Qiu
- Department of Cardiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Li Xu
- Department of Cardiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Geraldine Lee
- Catherine McAuley School of Nursing & Midwifery, Brookfield Health Sciences Complex, University College Cork, Cork, Ireland
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Isbanner S, Carins J, Babakhani N, Kitunen A. Streamlining COM-B model: Insights from the Healthy Eating Context. Appetite 2024; 203:107693. [PMID: 39341347 DOI: 10.1016/j.appet.2024.107693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2024] [Revised: 09/24/2024] [Accepted: 09/25/2024] [Indexed: 10/01/2024]
Abstract
The global rise in diet-related diseases highlights the urgent need for effective behavioural interventions. While theoretical frameworks like the Capability, Opportunity, Motivation-Behaviour (COM-B) model are valuable for understanding and influencing healthy eating behaviours, their practical application is often hindered by complexity and extensive measurement demands. This study addresses these challenges by testing a simplified version of the COM-B model, focusing on a select set of items representing seven core constructs. We conducted a cross-sectional survey with 347 Australian young adults to validate this streamlined model, making it more accessible for researchers and practitioners. Our findings underscore the importance of automatic motivation, the physical environment, and physical capability as critical factors in promoting healthy eating behaviours. By simplifying the COM-B model, this research contributes to developing more practical and effective strategies for healthier eating, addressing a critical public health issue.
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Affiliation(s)
- Sebastian Isbanner
- Education for Sustainable Nutrition and Food Science, Technische Universität Berlin, Berlin, 10623, Germany.
| | - Julia Carins
- Social Marketing @ Griffith, Griffith University, 170 Kessels Road, Nathan, QLD, 4111, Australia
| | - Nazila Babakhani
- Social Marketing @ Griffith, Griffith University, 170 Kessels Road, Nathan, QLD, 4111, Australia
| | - Anna Kitunen
- Social Marketing @ Griffith, Griffith University, 170 Kessels Road, Nathan, QLD, 4111, Australia
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Krężel P, Kurek E, Jurczak A, Napieracz-Trzosek I, Iłgowska D, Młyńska K, Wieder-Huszla S. Analysis of Compliance with Proper Nutrition Principles in Patients with a History of Myocardial Infarction. Nutrients 2024; 16:3091. [PMID: 39339696 PMCID: PMC11435254 DOI: 10.3390/nu16183091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2024] [Revised: 09/02/2024] [Accepted: 09/11/2024] [Indexed: 09/30/2024] Open
Abstract
Adherence to dietary recommendations and the implementation of appropriate dietary habits after myocardial infarction (MI) can significantly improve health and reduce mortality from cardiac causes. The aim of this study was to analyse the adherence of patients with a history of MI to a healthy diet, which is one of the primary methods of cardiovascular disease (CVD) prevention. Following a proper diet involves limiting the consumption of saturated fats, salt, alcohol, and simple sugars. It is recommended to follow the Mediterranean diet, which is based on whole grains, fruits, vegetables, and fish. This study involved 120 patients hospitalised in the Invasive Cardiology and Cardiac Intensive Care Unit at the Independent Public Voivodship Hospital in Szczecin from August to December 2019. A self-designed questionnaire and the Questionnaire of Eating Behaviour (QEB) were used. The majority of respondents were hospitalised for a first-time MI (88.33%), and 65% of them reported adherence to the recommendations. The vast majority (78.33%) considered their diet good, with 50.83% of the respondents eating four meals a day and never eating fast food (49.17%). The analysis showed that although the respondents' diets did not contain many unhealthy foods, they did not consume enough vegetables, fruits, fish, nuts, or fibre, which have a protective effect, lowering the risk of cardiovascular diseases and death. Furthermore, patients with a better education had a higher level of knowledge. Respondents' knowledge of proper post-MI nutrition was sufficient, and their index of unhealthy diets was low, but they still made dietary mistakes and did not consume enough health-protective foods. These results indicate a need for further education.
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Affiliation(s)
- Patrycja Krężel
- Department of Specialized Nursing, Pomeranian Medical University in Szczecin, 71-210 Szczecin, Poland; (A.J.); (I.N.-T.); (S.W.-H.)
| | - Ewa Kurek
- Intensive Cardiac Care Unit, Independent Public Voivodship Hospital, ul. Arkońska 4, 71-455 Szczecin, Poland;
| | - Anna Jurczak
- Department of Specialized Nursing, Pomeranian Medical University in Szczecin, 71-210 Szczecin, Poland; (A.J.); (I.N.-T.); (S.W.-H.)
| | - Izabela Napieracz-Trzosek
- Department of Specialized Nursing, Pomeranian Medical University in Szczecin, 71-210 Szczecin, Poland; (A.J.); (I.N.-T.); (S.W.-H.)
| | - Dorota Iłgowska
- Deparment of Nursing, State University of Applied Sciences in Koszalin, 75-582 Koszalin, Poland;
| | - Katarzyna Młyńska
- Students’ Scientific Society of Department of Specialized Nursing, Pomeranian Medical University in Szczecin, 71-210 Szczecin, Poland;
| | - Sylwia Wieder-Huszla
- Department of Specialized Nursing, Pomeranian Medical University in Szczecin, 71-210 Szczecin, Poland; (A.J.); (I.N.-T.); (S.W.-H.)
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Shi Y, Xie XY, Lao AD, Shao L, Wang ZA, Zhang JE. Prevalence of physical inactivity and its determinants among older adults living in nursing homes: A cross-sectional study based on COM-B model. J Clin Nurs 2024. [PMID: 38867609 DOI: 10.1111/jocn.17325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 05/17/2024] [Accepted: 06/03/2024] [Indexed: 06/14/2024]
Abstract
AIMS To investigate the prevalence of physical inactivity in older adults living in nursing homes and explore the determinants of physical inactivity by using the Capability, Opportunity, Motivation-Behaviour model. DESIGN A multisite, cross-sectional study was performed by convenience sampling and questionnaire survey. METHODS A total of 390 nursing home residents were recruited from three nursing homes in Southern China from May 2022 to April 2023. The participants completed a self-designed general information questionnaire, Physical Activity Scale for the Elderly, Self-Efficacy for Exercise Scale, Exercise Benefits Scale, Patient Health Questionnaire-9 and the Short Physical Performance Battery test. Descriptive statistics, univariate analysis, Spearman correlation analysis, and ordinal logistic regression were applied for data analysis. RESULTS The prevalence of physical inactivity among the nursing home residents reached 88.46%. Ordinal logistic regression results showed that exercise self-efficacy, perceived exercise benefits, physical function, availability of physical activity instruction, having depression, number of chronic diseases and living with spouse were the main influencing determinants of physical inactivity and explained 63.7% of the variance. CONCLUSIONS Physical inactivity was considerable in nursing home residents in China and influenced by complex factors. Tailored measures should be designed and implemented based on these factors to enhance physical activity while considering the uniqueness of Chinese culture. IMPLICATIONS FOR THE PROFESSION AND PATIENT CARE Healthcare professionals should enhance physical activity of residents by increasing benefits understanding, boosting self-efficacy, improving physical function, alleviating depression and integrating personalized physical activity guidance into routine care services. And more attention should be paid to the residents who had more chronic diseases or did not live with spouse. IMPACT Physical inactivity is a significant problem in nursing home residents. Understanding physical inactivity and its determinants enables the development of tailored interventions to enhance their physical activity level. REPORTING METHOD This study was reported conforming to the STROBE statement. PATIENTS OR PUBLIC CONTRIBUTION Nursing home residents who met the inclusion criteria were recruited.
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Affiliation(s)
- Ying Shi
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| | - Xi-Yan Xie
- Department of Nursing, Home for the Aged Guangzhou, Guangzhou, China
| | - Ai-di Lao
- Department of Nursing, Home for the Aged Guangzhou, Guangzhou, China
| | - Lu Shao
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| | - Zhang-An Wang
- School of Nursing, Sun Yat-sen University, Guangzhou, China
- Department of Health Management, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Jun-E Zhang
- School of Nursing, Sun Yat-sen University, Guangzhou, China
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5
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Manczak EM, Millwood SN, Waxman M. A healthy balance: the ratio of social support-to-demands is associated with metabolic syndrome. J Behav Med 2024; 47:348-354. [PMID: 37946025 DOI: 10.1007/s10865-023-00456-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 10/15/2023] [Indexed: 11/12/2023]
Abstract
Metabolic syndrome is associated with increased risk for negative health events, decrements in quality of life, and greater health costs. The current study sought to identify whether the ratio of social support to social demands across multiple relationship types (spouse, friends, children, or other family members) were associated with concurrent metabolic syndrome in a nationally representative sample of US adults ages 32-40. Results indicate that the ratio of total social support to social demands was associated with a greater likelihood of meeting criteria for metabolic syndrome, even after statistically controlling for the effects of race, ethnicity, sex, age, income, and prior metabolic syndrome. When considering the relative contributions of each relationship type, greater support relative to demands from friends was the only relationship type that was significantly independently associated with lower likelihood of metabolic syndrome. Although not statistically significant, a trend-level negative association with spousal support/demands emerged, as did a trend-level positive association with support/demands from children. Taken together, the current study reaffirms the relevance of considering social support and demands with regards to metabolic syndrome and highlights the ways in which specific relationships may differentially relate to health risk.
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Affiliation(s)
- Erika M Manczak
- Department of Psychology, University of Denver, 2155 Race St., Denver, CO, 80208, USA.
| | - Summer N Millwood
- Department of Psychology, University of Denver, 2155 Race St., Denver, CO, 80208, USA
| | - Megan Waxman
- Department of Psychology, University of Denver, 2155 Race St., Denver, CO, 80208, USA
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Lev-Arey D, Gutman T, Levental O. Empowering Movement: Enhancing Young Adults' Physical Activity through Self-Determination Theory and Acceptance and Commitment Therapy-Based Intervention. Behav Sci (Basel) 2024; 14:130. [PMID: 38392483 PMCID: PMC10885898 DOI: 10.3390/bs14020130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 02/05/2024] [Accepted: 02/07/2024] [Indexed: 02/24/2024] Open
Abstract
OBJECTIVE This study aims to investigate the effectiveness of a combined Self-Determination Theory (SDT) and Acceptance and Commitment Therapy (ACT) intervention, the "Running Minds" program, in promoting physical activity (PA) among young adults. METHODS The intervention, consisting of eight sessions, targeted motivational and psychological barriers to PA. It intertwined SDT's core components (autonomy, competence, relatedness) with ACT's emphasis on mindfulness and value-driven actions. This study used a qualitative approach, collecting data through semi-structured interviews with twelve participants aged 20-35, conducted post-intervention. RESULTS Our reflexive thematic analysis of the interviews revealed five key themes: alignment with personal values, rewarding experience of the sessions, fulfillment of social connectedness, enhancement of both intrinsic and extrinsic motivation, and observable behavioral changes. These findings highlight the importance of aligning exercise with personal values and the role of supportive social environments in sustaining PA. CONCLUSIONS The integration of SDT and ACT in the "Running Minds" program appears to be a viable approach for enhancing motivation and adherence to PA among young adults. This study offers valuable insights for future PA interventions, underscoring the need for strategies that consider psychological and social dimensions. Limitations and Future Research: Despite the promising results, limitations include potential recall bias and the short duration of the study. Further research, especially focusing on more diverse groups and employing longitudinal designs, is recommended to broaden and substantiate these findings.
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Affiliation(s)
- Dalit Lev-Arey
- Department of Psychology, The Academic College of Tel Aviv-Yaffo, Rabenu Yerucham, 2, Tel Avi Yaffo 6816811, Israel
| | - Tomer Gutman
- Department of Psychology, The Academic College of Tel Aviv-Yaffo, Rabenu Yerucham, 2, Tel Avi Yaffo 6816811, Israel
| | - Orr Levental
- Department of Physical Education, Tel Hai Academic College, Upper Galilee 1220800, Israel
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Chen D, Zhang H, Wu J, Xue E, Guo P, Tang L, Shao J, Cui N, Wang X, Chen L, Ye Z. Effects of an Individualized mHealth-Based Intervention on Health Behavior Change and Cardiovascular Risk Among People With Metabolic Syndrome Based on the Behavior Change Wheel: Quasi-Experimental Study. J Med Internet Res 2023; 25:e49257. [PMID: 38019579 PMCID: PMC10720605 DOI: 10.2196/49257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 09/10/2023] [Accepted: 10/10/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND Metabolic syndrome (MetS) is a common public health challenge. Health-promoting behaviors such as diet and physical activity are central to preventing and controlling MetS. However, the adoption of diet and physical activity behaviors has always been challenging. An individualized mobile health (mHealth)-based intervention using the Behavior Change Wheel is promising in promoting health behavior change and reducing atherosclerotic cardiovascular disease (ASCVD) risk. However, the effects of this intervention are not well understood among people with MetS in mainland China. OBJECTIVE We aimed to evaluate the effects of the individualized mHealth-based intervention using the Behavior Change Wheel on behavior change and ASCVD risk in people with MetS. METHODS We conducted a quasi-experimental, nonrandomized study. Individuals with MetS were recruited from the health promotion center of a tertiary hospital in Zhejiang province, China. The study involved 138 adults with MetS, comprising a control group of 69 participants and an intervention group of 69 participants. All participants received health education regarding diet and physical activity. The intervention group additionally received a 12-week individualized intervention through a WeChat mini program and a telephone follow-up in the sixth week of the intervention. Primary outcomes included diet, physical activity behaviors, and ASCVD risk. Secondary outcomes included diet self-efficacy, physical activity self-efficacy, knowledge of MetS, quality of life, and the quality and efficiency of health management services. The Mann-Whitney U test and Wilcoxon signed rank test were primarily used for data analysis. Data analysis was conducted based on the intention-to-treat principle using SPSS (version 25.0; IBM Corp). RESULTS Baseline characteristics did not differ between the 2 groups. Compared with the control group, participants in the intervention group showed statistically significant improvements in diet behavior, physical activity behavior, diet self-efficacy, physical activity self-efficacy, knowledge of MetS, physical health, and mental health after a 12-week intervention (P=.04, P=.001, P=.04, P=.04, P=.001, P=.04, P=.04, and P<.05). The intervention group demonstrated a statistically significant improvement in outcomes from pre- to postintervention evaluations (P<.001, P=.03, P<.001, P=.04, P<.001, P<.001, and P<.001). The intervention also led to enhanced health management services and quality. CONCLUSIONS The individualized mHealth-based intervention using the Behavior Change Wheel was effective in promoting diet and physical activity behaviors in patients with MetS. Nurses and other health care professionals may incorporate the intervention into their health promotion programs.
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Affiliation(s)
- Dandan Chen
- Nursing Department, Affiliated Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Hui Zhang
- Department of Nursing, Guizhou Provincial People's Hospital, Guiyang, China
| | - Jingjie Wu
- Nursing Department, Affiliated Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Erxu Xue
- Nursing Department, Affiliated Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Pingping Guo
- Nursing Department, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Leiwen Tang
- Institute of Nursing Research, Zhejiang University School of Medicine, Hangzhou, China
| | - Jing Shao
- Institute of Nursing Research, Department of Nursing of the Fourth Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Nianqi Cui
- School of Nursing, Kunming Medical University, Kunming, China
| | - Xiyi Wang
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Liying Chen
- Nursing Department, Affiliated Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Zhihong Ye
- Nursing Department, Affiliated Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
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Chen D, Shao J, Zhang H, Wu J, Xue E, Guo P, Tang L, Cui N, Wang X, Chen L, Ye Z. Development of an individualized WeChat mini program-based intervention to increase adherence to dietary recommendations applying the behaviour change wheel among individuals with metabolic syndrome. Ann Med 2023; 55:2267587. [PMID: 37898907 PMCID: PMC10836251 DOI: 10.1080/07853890.2023.2267587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 09/22/2023] [Indexed: 10/31/2023] Open
Abstract
BACKGROUND Metabolic Syndrome (MetS) is a serious public health issue. Dietary changes form the core of MetS treatment. The adherence to dietary recommendations is critical for reducing the severity of MetS components and preventing complications. However, the adherence to dietary recommendations was not adequate among adults with MetS. This study utilizes the Behaviour Change Wheel (BCW) to develop an individualized WeChat mini program-based behavioural change intervention aimed at strengthening adherence to dietary recommendations in people with MetS. METHODS The BCW theory was used to design an individualized WeChat mini program-based behavioural change intervention. A descriptive qualitative study was conducted to identify the determinants of adherence to dietary recommendations in individuals with MetS. The study was conducted at the health promotion centre of a prominent general university hospital in Zhejiang, China. Subsequently, the intervention functions (IFs) and policy categories were selected following the identified determinants. Afterwards, behaviour change techniques (BCTs) were chosen to translate into potential intervention strategies, and the delivery mode was determined. RESULTS Our study identified fifteen barriers to improve the adherence to dietary recommendations in this population. These were linked with six IFs: education, training, persuasion, enablement, modelling, and environmental restructuring. Then, twelve BCTs were linked with the IFs and fifteen barriers. The delivery mode was a WeChat mini program. After these actions, an individualized WeChat mini program-based behavioural change intervention was developed to enhance adherence to dietary recommendations for individuals with MetS. CONCLUSIONS The BCW theory helped scientifically and systematically develop an individualized WeChat mini program-based behavioural change intervention for individuals with MetS. In the future, our research team will refine and upgrade the WeChat mini program and then test the usability and effectiveness of the individualized WeChat mini program-based behavioural change intervention program.
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Affiliation(s)
- Dandan Chen
- Nursing Department, Affiliated Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jing Shao
- School of Nursing, Zhejiang University School of Medicine, Hangzhou, China
| | - Hui Zhang
- Department of Cardiology, Guizhou Provincial People's Hospital, Guiyang, China
| | - Jingjie Wu
- Nursing Department, Affiliated Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Erxu Xue
- Nursing Department, Affiliated Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Pingping Guo
- Nursing Department, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Leiwen Tang
- Nursing Department, Affiliated Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Nianqi Cui
- School of Nursing, Kunming Medical University, Kunming, China
| | - Xiyi Wang
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Liying Chen
- Department of General Practice, Affiliated Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Zhihong Ye
- Nursing Department, Affiliated Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
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Kim Y, Park S. Factors Associated with Prevention of Metabolic Syndrome Among Middle-Aged Postmenopausal Korean Women: A Study Based on the Information, Motivation, Behavioral Skills (IMB) Model. Patient Prefer Adherence 2023; 17:2279-2288. [PMID: 37727146 PMCID: PMC10506598 DOI: 10.2147/ppa.s426248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 09/08/2023] [Indexed: 09/21/2023] Open
Abstract
Purpose Metabolic syndrome (MetS) is a significant risk factor for cardiovascular disease. Middle-aged women, in particular, have been reported to have significantly increased cardiovascular disease rates after menopause; however, their adherence to health behaviors is lower than that of other populations. This study examined the factors associated with health behaviors for MetS prevention based on the Information-Motivation-Behavior skills model and described the relationships between the components of the model in middle-aged women. Patients and Methods This investigative study used an online self-report questionnaire survey that included 241 middle-aged postmenopausal women aged 45-64 years. The collected data were analyzed using descriptive statistics with SPSS 28.0, independent t-tests, one-way ANOVA, and Pearson's correlation coefficient. Multiple regression analysis was used to examine the relationships among the variables. Results After controlling for age, time since menopause, and comorbidities, knowledge of MetS, social support, self-efficacy, and attitudes explained 42% of the variance in health behaviors for MetS prevention (F=18.38, p<0.001). Among these variables, self-efficacy (β=0.33, p<0.001), attitudes toward health behaviors (β=0.26, p<0.001), and knowledge of MetS (β=0.13, p=0.005) had a significant impact on health behaviors for MetS prevention. Conclusion Significant associations were found between knowledge, self-efficacy, and attitudes toward health behaviors for MetS prevention among middle-aged women. The results of this study suggest that it is essential for healthcare provider to consider the components of the Information-Motivation-Behavior skills model when developing interventions aimed at improving health behaviors for MetS prevention among middle-aged postmenopausal women.
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Affiliation(s)
- Yoonjung Kim
- College of Nursing, Konyang University, Daejeon, Republic of Korea
| | - Sooyeon Park
- College of Nursing, Konyang University, Daejeon, Republic of Korea
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Basciani S, Nordio M, Dinicola S, Unfer V, Gnessi L. Diet Plus Inositols, α-Lactalbumin and Gymnema sylvestre: The Successful Combo to Restore Body Weight and Metabolic Profile in Obese and Dysmetabolic Patients. Nutrients 2023; 15:3142. [PMID: 37513560 PMCID: PMC10385591 DOI: 10.3390/nu15143142] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 07/11/2023] [Accepted: 07/12/2023] [Indexed: 07/30/2023] Open
Abstract
The primary control of dysmetabolic patients is extremely challenging worldwide, with inadequate dietary habits and sporadic physical activity among the key risk factors for metabolic syndrome onset. Nowadays, there is no exclusive treatment for this condition, and considering that preventive measures usually fail, new therapeutic approaches need to be proposed and investigated. This present pilot study compared the effects of diet alone and in association with a combination of myo-inositol and d-chiro-inositol in their 40:1 ratio, α-lactalbumin, and Gymnema sylvestre on different metabolic parameters in obese dysmetabolic patients. To this purpose, 37 patients with BMI between 30 and 40 and fasting blood glucose between 100 and 125 mg/dL were divided into two groups: (i) the control group followed a hypocaloric Mediterranean diet, (ii) while the study group was also supplemented with a daily dosage of two sachets, each one containing 1950 mg myo-inositol, 50 mg d-chiro-inositol, 50 mg α-lactalbumin, and 250 mg Gymnema Sylvestre. After a 6-month treatment, all parameters improved in both groups. Nevertheless, the treated group experienced a greater improvement, especially concerning the variation from the baseline of HOMA index, triglycerides, BMI, body weight, and waist circumference. These findings support the supplementation with myo-inositol and d-chiro-inositol in the 40:1 ratio, α-lactalbumin, and Gymnema sylvestre as a therapeutical strategy to potentiate the beneficial effects induced via dietary programs in dysmetabolic patients.
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Affiliation(s)
- Sabrina Basciani
- Section of Medical Pathophysiology, Food Science and Endocrinology, Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy
| | - Maurizio Nordio
- Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy
- The Experts Group on Inositol in Basic and Clinical Research (EGOI), 00161 Rome, Italy
| | - Simona Dinicola
- The Experts Group on Inositol in Basic and Clinical Research (EGOI), 00161 Rome, Italy
- R&D Department, Lo.Li. Pharma, 00156 Rome, Italy
| | - Vittorio Unfer
- The Experts Group on Inositol in Basic and Clinical Research (EGOI), 00161 Rome, Italy
- UniCamillus-Saint Camillus International University of Health Sciences, 00131 Rome, Italy
| | - Lucio Gnessi
- Section of Medical Pathophysiology, Food Science and Endocrinology, Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy
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11
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Chen D, Zhang H, Cui N, Song F, Tang L, Shao J, Wu J, Guo P, Liu N, Wang X, Ye Z. Development of a behavior change intervention to improve physical activity adherence in individuals with metabolic syndrome using the behavior change wheel. BMC Public Health 2022; 22:1740. [PMID: 36104817 PMCID: PMC9471053 DOI: 10.1186/s12889-022-14129-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 08/23/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Adherence to physical activity is inadequate in adults with metabolic syndrome. Adherence to physical activity recommendations is crucial and can result in improved health outcomes and reduced medical burdens. A comprehensive behavior change intervention, including identifying determinants of adherence to physical activity recommendations, intervention options, intervention content and implementation options, was imperative for enhancing physical activity adherence. The aim of the study is to develop an intervention to increase physical activity adherence among individuals with metabolic syndrome.
Methods
The study followed the eight steps of the Behavior Change Wheel guide, including defining the problem in behavioral terms (Step 1), selecting target behavior (Step 2), specifying target behavior (Step 3), identifying what needs to change (Step 4), identifying intervention functions (Step 5), identifying policy categories (Step 6), identifying behavior change techniques (Step 7), and determining model of delivery (Step 8). The semi-structured, in-depth interviews were employed to identify the determinants of adherence to physical activity among twenty-eight individuals with metabolic syndrome based on capability, opportunity, motivation and behavior model. Next, the intervention functions and policy categories were chosen to address these determinants. Finally, behavior change techniques were selected to assist in the delivery of the intervention functions and be translated into intervention content.
Results
Our study identified eighteen facilitators and fifteen barriers to physical activity adherence. It resulted in the selection of seven intervention functions and nineteen behavior change techniques for the intervention program. Then, the current study identified an app as the delivery mode. Finally, a behavioral change intervention was generated for individuals with metabolic syndrome to increase physical activity recommendation adherence.
Conclusions
The Behavior Change Wheel provided a systematic approach to designing a behavior change intervention, which helped improve the health outcomes and reduce medical burdens and economic burdens among individuals with metabolic syndrome. The findings suggested that potential intervention should pay special attention to increasing knowledge in metabolic syndrome, imparting skills of physical activity, offering a supportive environment, and providing suggestions on regular physical activity using the appropriate behavior change techniques. A feasibility study will be undertaken to assess the acceptability and effectiveness of the intervention program in the future.
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