Intervención enfermera en prevención secundaria a pacientes con cardiopatía isquémica en Atención Primaria

  1. Gema Gallego Treviño
  2. Concepción Carratalá Munuera
  3. Miguel Ánglel Núñez Martínez
  4. Antoni Pastor Monerris
  5. Elena López Acuña
  6. Loreto Cruz Bonmati
Revista:
Revista Iberoamericana de Enfermería Comunitaria: RIdEC

ISSN: 1988-5474

Any de publicació: 2014

Títol de l'exemplar: Enfermería Comunitaria

Volum: 7

Número: 1

Pàgines: 57-69

Tipus: Article

DIALNET GOOGLE SCHOLAR lock_openAccés obert editor

Altres publicacions en: Revista Iberoamericana de Enfermería Comunitaria: RIdEC

Resum

Patients with cardiovascular diseases deserve a highest priority in cardiovascular prevention due to: their risk is higher, interventions are more effective, and a larger benefit can be obtained. However less than 50% of patients reach a good control of main risk factors (LDL-cholesterol, blood pressure). Purpose: Novel models for chronic care provide new procedural strategies that can be used in these patients. Such models have been implemented in the present study to alter adherence to non-pharmacological measures (diet, physical activity, smoking). Methods: Six individual nursing visits were planned over a one-year follow-up period. The following items were assessed: Mediterranean diet (14-point scale), exercise, smoking, and blood pressure control (BP < 140/90) and laboratory findings (LDL-cholesterol <100 mg/dl). Results and conclusions: The following changes from baseline values were observed at the end of the program: usual physical activity (67.7 vs 86.2; p < 0.05); non-smokers (84.2 vs 94.6; p < 0.05); SBP < 140 mmHg (70.2 vs 76.0; p < 0.05); DBP < 90 mmHg (93.0 vs 95.2 NS); Mediterranean diet score (9.7 vs 10.5; p < 0.05). Furthermore, a 37% decrease from previous year in clinic visits over one year was observed (13.04 vs 8.06; p < 0.05). Nursing intervention has improved risk factors in patients with ischemic heart disease.

Referències bibliogràfiques

  • Maiques-Galán A, Brotons-Cuixart C, Villar-Álvarez F, Navarro J, Lobos JM, Ortega R, Martín-Rioboó E, Banegas JR, Orozco-Beltrán D, Gil- Guillén V. Recomendaciones preventivas cardiovasculares. Aten Primaria 2012; 44(1):3-15.
  • Gutiérrez-Fisac JL, López E, Banegas JR, Graciani A, Rodríguez-Artalejo F. Prevalence of overweight and obesity in elderly people in Spain. Obes Res 2004; 12:710-5.
  • Ministerio de Sanidad y Consumo. Encuesta Nacional de Salud de España. Madrid: Ministerio de Sanidad y Consumo; 2005, 2007.
  • Instituto Nacional de Estadística, INEbase. [En línea] [fecha de acceso: 4 de diciembre de 2013]. URL disponible en: http://www.ine.es/inebase/
  • Franz MJ, VanWormer JJ, Crain AL, Boucher JL, Histon T, Caplan W, Bowman JD, Pronk NP. Weight-loss outcomes: a systematic review and meta-analysis of weight-loss clinical trials with a minimum 1-year follow-up. J Am Diet Assoc 2007; 107:1755-67.
  • Harrington M, Gibson S, Cottrell RC. A review and meta-analysis of the effect of weight loss on all-cause mortality risk. Nutr Res Rev 2009 Jun; 22(1):93-108.
  • Ismail I, Keating SE, Baker MK, Johnson NA. A systematic review and meta-analysis of the effect of aerobic vs. resistance exercise training on visceral fat. Obes Rev 2012; 13:68-91.
  • Kay SJ, Fiatarone Singh MA. The influence of physical activity on abdominal fat: a systematic review of the literature. Obes Rev 2006; 7(2):183-200.
  • Lawler PR, Filion KB, Eisenberg MJ. Efficacy of exercise-based cardiac rehabilitation post-myocardial infarction: a systematic review and metaanalysis of randomized controlled trials. Am Heart J 2011 Oct; 162(4):571-584.
  • Ebrahim S, Taylor F, Ward K, Beswick A, Burke M, Davey Smith G. Multiple risk factor interventions for primary prevention of coronary heart disease. Cochrane Database Syst Rev 2011; (1):CD001561.
  • Banegas JR, Rodríguez-Artalejo F, Graciani A, Villar F, Herruzo R. Mortality attributable to cardiovascular risk factors in Spain. Eur J Clin Nutr 2003; 57(1):S18–S21.
  • Muñoz MA, Vila J, Cabañero M, Rebato C, Subirana I, Sala J, Marrugat J, ICAR (Intervención en la Comunidad de Alto Riesgo cardiovascular). Efficacy of an intensive prevention program in coronary patients in primary care, a randomized clinical trial. Int J Cardiol 2007; 118:312- 320.
  • Graham I, Atar D, Borch-Johnsen K, Boysen G, Burell G, Cifkova R, et al. European Society of Cardiology (ESC) committee for practice guidelines (CPG). European Guidelines on Cardiovascular Disease Prevention in Clinical Practice: executive summary: fourth joint task force of the european society of cardiology and other societies on cardiovascular disease prevention in clinical practice (constituted by representatives of nine societies and by invited experts). Eur Heart J 2007; 28:2375–414.
  • Lobos JM, Royo-Bordonada MA, Brotons C, Álvarez-Sala L, Armario P, Maiques A, Mauricio D, et al. y el Comité Español Interdisciplinario para la Prevención Cardiovascular: European guidelines on cardiovascular disease prevention in clinical practice: CEIPC 2008 spanish adaptation. Rev Clin Esp 2009; 209(6):279–302.
  • Selby JV, Schmittdiel JA, Fireman B, Jaffe M, Ransom LJ, Dyer W, et al. Improving treatment intensification to reduce cardiovascular disease risk: a cluster randomized trial. BMC Health Serv Res 2012; 12:183.
  • Kotseva K, Wood D, De Backer G, De Backer D, Pyörälä K, Keil U, the EUROASPIRE Study Group: Cardiovascular prevention guidelines in daily practice: a comparison of EUROASPIRE I, II, and III surveys in eight European countries. Lancet 2009; 373:929–940.
  • Orozco-Beltrán D, Brotons C, Moral I, Soriano N, Del Valle MA, Rodríguez Al, Pepió JM, Pastor A, PREseAP study group: Factors affecting the control of blood pressure and lipid levels in patients with cardiovascular disease: the PREseAP study. Rev Esp Cardiol 2008; 61(3):317-321.
  • Brotons C, Soriano N, Moral I, Rodrigo MP, Kloppe P, Rodríguez Al, et al. PREseAP study research team. Randomized clinical Trial to assess the efficacy of a comprehensive programme of secondary prevention cardiovascular disease in general practice: the PREseAP study. Rev Esp Cardiol 2011; 64(1):13-20.
  • Muñoz MA, Rohlfs I, Masuet S,Rebato C, Cabañero M, Marrugat J, ICAR Study Group. Analysis of inequalities in secondary prevention of coronary heart disease in a universal coverage health care system. Eur J Public Health 2006; 16(4):361-367.
  • Orozco Beltrán D, Ruescas Escolano E, Navarro Palazón AI, Cordero A, Gaubert Tortosa M, Navarro Pérez J, et al. Effectiveness of a new health care organization model in primary care for chronic cardiovascular disease patients based on a multifactorial intervention: the PROPRESE randomized controlled trial. BMC Health Serv Res 2013; 13(1):293.
  • Gil Guillén V, Orozco Beltrán D, Redón J, Pita Fernández S, Navarro Pérez J, Pallarés V, et al. Rationale and methods of the cardiometabolic Valencian study (Escarval-Risk) for validation of risk scales in Mediterranean patients with hypertension, diabetes or dyslipidemia. BMC Public Health 2010; 10:717.
  • Salas Salvadó J, Fernández Ballart J, Ros E, Martínez González MA, Fitó M, Estruch R, et al. PREDIMED Study Investigators. Effect of a Mediterranean diet supplemented with nuts on metabolic syndrome status: one-year results of the PREDIMED randomized trial. Arch Intern Med 2008; 168(22):2449-58.
Fuente de los datos: Dialnet