Aim. The overall aims of this study were to develop a Chinese version Heart Manual and to examine its effectiveness in enhancing the health-related quality of life (HRQL) and psychological status of Chinese patients recovering from AMI. / Conclusion. The findings of this study provide evidence of areas, including the development of a culturally relevant needs-based Heart Manual, and the consideration of a home-based rehabilitation strategy, that could contribute to the development and improvement of cardiac rehabilitation in China. The study provides a unique tool to help Chinese nurses to meet the cardiac rehabilitative care needs of AMI patients. The study can also generate a much-needed impetus and indicate the direction for the development of cardiac rehabilitation nursing, especially home-based self-managed rehabilitative care in China. / Methods. In the first place, qualitative research was conducted to generate data regarding the experiences and needs of Chinese patients and their spouses immediately after their discharge from hospital following a first heart attack, and the views and beliefs of Chinese health professionals' concerning cardiac rehabilitative care in the hospitals of China. The information gained from the couples and health professionals was used to develop a Chinese version Heart Manual that is tailored to patient needs and adapted to the local culture. / Patients in the experimental group demonstrated better progress across a 6-month period than the control group, in terms of: significantly greater improvements in seven of eight domains of generic HRQL (p = 0.031-0.002) as assessed by the Chinese Mandarin version of Short Form 36-item healthy survey (CM:SF-36) and in five of seven dimensions of disease-specific HRQL (p = 0.008-0.000) as measured by the Chinese Mandarin version of Myocardial Infarction Dimensional Assessment Scale (CM-MIDAS); a significantly greater reduction in anxiety (p = 0.046) as assessed by the Chinese version of Hospital Anxiety and Depression Scale (C-HADS); a significantly greater reduction in the serum lipids of triglyceride (p = 0.04), total cholesterol (p = 0.01) and low-density lipoprotein (p = 0.01); a significantly better control of diastolic blood pressure (p = 0.02); and significantly fewer unplanned cardiac-related medical consultations (p = 0.035). However, the effects of the rehabilitation programme on depression, smoking cessation, serum lipids of high-density lipoprotein, systolic blood pressure, body mass index and blood glucose, as well as unplanned cardiac-related hospital readmissions and emergency room visits were not confirmed in this study. / Results. The Chinese version Heart Manual contains three sections. The first section consists of six weekly topics to educate the patient on coronary heart disease. The second section answers commonly asked questions about medication, Percutaneous Coronary Intervention (PCI), sexual life after a heart attack, and anxiety and depression after a heart attack. The third section presents information on the normal values for blood pressure, blood glucose and serum lipids, as well as on the saturated and unsaturated fats to be found in daily foods. A panel of experts and the potential users were invited to evaluate the validity of the contents in terms of the accuracy, appropriateness and applicability of the Manual. All of the content was considered to be accurate and appropriate by the expert panel, and the potential users found it was easy to understand and to follow. / Then, a randomized control group study with repeated measures was used to examine the effectiveness of a six-week home-based cardiac rehabilitation programme using the Chinese version Heart Manual. A total of 160 participants were recruited, and randomly assigned to either the experimental or the control group. Participants in the experimental group received the Chinese version Heart Manual at their discharge, and both groups received the usual care from the hospital. A telephone follow-up to both groups was made 3 weeks after hospital discharge. The outcomes measured included health-related quality of life, psychological status, smoking status, cardiac physiological risk parameters and unplanned health service use. Data collection was conducted at the baseline, at 6 weeks when the programme ended, and at 3 months and 6 months after hospital discharge. Inferential statistics, such as the multivariate repeated measures ANOVA, the Chi-square test, the Mann-Whitney U test and the Friedman test, were used to compare the differences of outcome variables between the experimental and the control group across the 6 months of the study period. / Wang, Wenru. / "November 2007." / Advisers: Sheila Twinn; Sek Ying Chair. / Source: Dissertation Abstracts International, Volume: 69-08, Section: B, page: 4671. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2007. / Includes bibliographical references (p. 297-337). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstract in English and Chinese. / School code: 1307.
| Identifer | oai:union.ndltd.org:cuhk.edu.hk/oai:cuhk-dr:cuhk_344094 |
| Date | January 2007 |
| Contributors | Wang, Wenru, Chinese University of Hong Kong Graduate School. Division of Nursing. |
| Source Sets | The Chinese University of Hong Kong |
| Language | English, Chinese |
| Detected Language | English |
| Type | Text, theses |
| Format | electronic resource, microform, microfiche, 1 online resource (xxiv, 434 p. : ill.) |
| Rights | Use of this resource is governed by the terms and conditions of the Creative Commons “Attribution-NonCommercial-NoDerivatives 4.0 International” License (http://creativecommons.org/licenses/by-nc-nd/4.0/) |
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