Heart up! RCT protocol to increase physical activity in cardiac patients who report hopelessness: Amended for the COVID-19 pandemic.
Research in nursing & health. 2021;(2):279-294
Hopelessness is associated with decreased physical activity (PA) and increased adverse events and death in patients with ischemic heart disease (IHD). Rates of PA in patients with IHD continue to be low in both hospital-based cardiac rehabilitation and home settings. While researchers have investigated strategies to increase PA among patients with IHD, interventions to promote PA specifically in IHD patients who report hopelessness are lacking. We describe the protocol for a NIH-funded randomized controlled trial designed to establish the effectiveness of a 6-week intervention (Heart Up!) to promote increased PA in IHD patients who report hopelessness. Participants (n = 225) are randomized to one of three groups: (1) motivational social support (MSS) from a nurse, (2) MSS from a nurse plus significant other support (SOS), or (3) attention control. Aims are to: (1) test the effectiveness of 6 weeks of MSS and MSS with SOS on increasing mean minutes per day of moderate to vigorous PA; (2) determine the effects of change in moderate to vigorous PA on hopelessness; and (3) determine if perceived social support and motivation (exercise self-regulation) mediate the effects of the intervention on PA. A total of 69 participants have been enrolled to date. The protocol has been consistently and accurately used by research personnel. We address the protocol challenges presented by the COVID-19 pandemic and steps taken to maintain fidelity to the intervention. Findings from this study could transform care for IHD patients who report hopelessness by promoting self-management of important PA goals that can contribute to better health outcomes.
Phase 3 rehabilitation: an underused tool for consolidation of lifestyle changes, and prevention of relapses in cases of ischemic heart disease.
Panminerva medica. 2021;(2):193-198
The third phase of the Cardiac Rehabilitation Program (CRP) is a lifelong, maintenance phase beginning 3 to 6 months after the cardiac event. Individualized surveillance and monitoring schedules are established. The exercise prescription guidelines are practically identical to those of the other phases of the CRP with personalized monitoring. Currently, with the emergence of the COVID-19 pandemic, telerehabilitation and telemonitoring are of great value in this phase. The benefits of phase 3 have been demonstrated with prolonged survival by 1.82 years, at a cost of $ 1773 per year of life saved.