Efficacy of team work in health promotion and secondary prevention in patients admitted for cardiovascular rehabilitation

Abstract

IntroduzioneLe malattie cardiovascolari sono la prima causa di morte in Italia, essendo responsabili del 44% del totale dei decessi. Analizzando inoltre la distribuzione dei fattori di rischio emerge che il 33% degli uomini e il 31% delle donne è iperteso, il 21% degli uomini e il 25% delle donne presenta ipercolesterolemia, il 34% degli uomini e il 40% delle donne non svolge alcuna attività fisica, il 18% degli uomini e il 22% delle donne è obeso mentre il 9% degli uomini e il 6% delle donne è diabetico [1].La finalità della Riabilitazione Cardiovascolare (RCV) include, oltre al recupero fisico del soggetto, anche quello psicologico; pertanto è necessaria anche l'analisi della condizioni emotive, cognitive e sociali del paziente, a cui si deve aggiungere un'adeguata educazione sanitaria per poter correggere e migliorare quegli aspetti disfunzionali connessi alla presenza di fattori di rischio coronarico [2].Per ridurre l'impatto delle malattie cardiovascolari è fondamentale eliminare i fattori di rischio modificando le abitudini scorrette e adottando uno stile di vita salutare. In particolare, per gestire correttamente la malattia, i pazienti dovrebbero conoscere la natura e la sua evoluzione, i fattori di rischio che possono condizionarne la progressione e gli stili di vita che ne rallentano il decorso e prevengono le recidive [3]. Dalla letteratura emerge però che numerose persone assistite vengono dimesse senza possedere le adeguate conoscenze in merito alla patologia e ai possibili trattamenti [4][5][6][7][8].L'educazione sanitaria diventa quindi una delle componenti fondamentali dell'intervento di riabilitazione cardiologia; diverse esperienze, infatti, hanno dimostrato che gli interventi educativi contriEfficacia del lavoro di gruppo nella informazione sanitaria e prevenzione secondaria in pazienti afferenti alla riabilitazione cardiologica Methods: from October 2008 a multiprofessional group organized educational meetings for patients and their relatives, using two questionnaires to explore patients' level of knowledge, before and after the meeting.Results: 124 patients (90 males) answered the questionnaire 1, while questionnaire 2 was completed by 93 subjects (70 males). From the answers to questionnaire 1, a significant improvement of knowledge about coronary anatomy and cardiovascular therapy emerged. Indeed, 99% of patients vs 81% before the meeting (p=0.001) understood the coronary artery function, 69% vs 44% (p=0,0001) of participants was familiar with coronary angioplasty, 81% vs. 64% (p=0,003) demonstrated to understand the coronary artery bypass and finally 85% vs. 52% (p=0,0001) were able to distinguish mechanical from biological prosthesis. From answers to questionnaire 2, a trend in favour to an improvement of knowledge regarding coronary risk factors and correct life style emerged. Younger patients (<70 ys) had a higher baseline level knowledge (p=0,003 and p=0.001 group 1 and 2, respectively) compared to older subjects, but in the latter a trend in favour of enhanced knowledge (p=0.06) afte...

Knowledge on cardiovascular risk factors improves the effectiveness of rehabilitation following acute coronary syndrome

“…smoking habit) are some of the reasons for this situation [18,19]. In our study the demographic and clinical profile of the subjects was comparable to that described in numerous papers on knowledge on CV risk factors and secondary prevention [20][21][22]. Therefore, we may assume that our findings are representative for the population.…”

Ocena czynników ryzyka chorób układu sercowo-naczyniowego u chorych poddawanych stacjonarnej wczesnej rehabilitacji kardiologicznej po ostrym incydencie wieńcowym

“…Increased awareness of the problem of secondary prevention and understanding of the role of multidisciplinary teams have enabled the development of comprehensive cardiac rehabilitation programs, including physiotherapy, occupational therapy, education, psychological and social therapy, counseling for risk factors and pharmacotherapy [3][4][5][6]. Comprehensive cardiac rehabilitation has become a platform that connects many medical specialties, but also family members and their immediate environment.…”

“…This applies both to the profile of patients participating in the rehabilitation program, including their cardiovascular risk burden, and to the level of knowledge and awareness of secondary prevention. The patients participating in cardiac rehabilitation program are mainly men (60-80%), over 60 years of age, hypertensive, overweight or obese (60-80%), with diabetes (10-30%), OR -odds ratio; CI -confidence interval; HDL -high-density lipoprotein; LDL -low-density lipoprotein dyslipidemia (50-80%), current smokers (10-40%), and frequently fulfilling the diagnostic criteria of metabolic syndrome [4][5][6]. The knowledge of patients after acute coronary syndrome who underwent invasive treatment is negligible or inadequate in relation to the health risk [10,[15][16][17][18][19].…”

“…This is only possible, if the patient is aware that prevention is necessary and cooperates with a multidisciplinary therapeutic team, which at this stage is composed primarily of a physician, nurse, physiotherapist, psychologist and social worker [5,6].…”

“…Despite implementing numerous social education programs, a significant proportion of patients do not follow lifestyle modification recommendations, and their knowledge of risk factors is insufficient [4][5][6]. Often, they are convinced that their heart disease is caused by non-modifiable (genetic, innate) factors rather than by modifiable factors associated with daily behavior [7].…”