The Effectiveness of a Multibehavioral Intervention on Psychological CVD Risk Factors in Older Men

2.50
Hdl Handle:
http://hdl.handle.net/10755/150735
Type:
Presentation
Title:
The Effectiveness of a Multibehavioral Intervention on Psychological CVD Risk Factors in Older Men
Abstract:
The Effectiveness of a Multibehavioral Intervention on Psychological CVD Risk Factors in Older Men
Conference Sponsor:Sigma Theta Tau International
Conference Year:2002
Conference Date:July, 2002
Author:McCrone, Susan
P.I. Institution Name:West Virginia University
Title:Associate Professor
Objective: To determine the effectiveness of a multibehavioral intervention to decrease psychological cardiovascular disease (CVD) risk factors in older men. Design: A two group, pre - posttest quasi experimental design was used to test the hypothesis: Men in the multibehavioral intervention (exercise, nutrition and stress management) will experience a significantly greater reduction in psychological CVD risk factors than men in the attention control group (exercise, nutrition and health education). Population, Sample, Setting, Years: The population for the study was all men who had expressed interest in an exercise or nutrition program conducted by investigators at the facility. The convenience sample consisted of 32 men who had undergone baseline testing, met inclusion criteria and indicated that they would be available for a six - month intervention program. The study was conducted at an urban Veteran's Administration Medical Center in the mid-Atlantic region of the United States. Interventions: Both groups received the same exercise and nutrition components of the intervention. The exercise component consisted of an individually designed treadmill program that occurred at the facility twice a week for six months. The goal of the exercise program was to reach at least 70 % of the participant's heart rate reserve for at least 40 minutes. The nutrition component was taught by a research dietician in a one-hour classroom session for 12 weeks. Emphasis was on healthy eating not dieting. At the completion of the class, the multibehavioral group received 12 weeks of stress management class instruction taught by a doctorally prepared nurse. The stress management component was based on a cognitive behavioral social learning theory model. It targeted the interaction of the social environment with personality traits that predispose individuals to react to a situation in a particular way. Techniques included: monitoring of irrational thoughts, thought stopping, generating alternative interpretations of situations, assertiveness training, and time management. Participants were taught progressive muscle relaxation and given an audiotape to facilitate practice at home. The attention control group received 12 weeks of health education taught by the same nurse. Sessions included: cardiovascular risk, attaining a healthy lifestyle, time management and incorporating exercise. No stress management content was included. Outcome Variables: Depression - Geriatric Depression Scale, Anxiety - Spielberger State-Trait Anxiety Scale, Anger - Spielberger Anger Expression Scale, Stress - Perceived Stress Scale Methodology: Questionnaires were sent to 160 men and 120 were returned (80% return rate). Ninety men indicated that they would be interested in further testing and completed at least one baseline clinic visit, which included completion of the CES-D (a depression screening tool) and the Mini-Mental State Exam. Inclusion criteria included: over age 55, no recent MI or stroke, no current alcoholism, ability to exercise, score above 16 on the CES-D and score above 27 on the Mini-Mental State Exam. Of the men meeting inclusion criteria, 32 men indicated interest in a six-month intervention program and were assigned to groups based upon their availability. Findings: Of the 32 men beginning the study, 30 completed (6% attrition). Demographic characteristics of the sample included: mean age 66.4 years + 5.5 years, 100% Caucasian, 78% married, 76% some college and 62% retired. There were no significant between group differences on any demographic variable. Baseline analyses revealed group differences on anger in, and total anger scales with the experimental group scoring significantly higher. From pretest to posttest, the experimental group decreased scores on the depression (p < .001), trait anxiety (p < .001), total anger (p < .05), and perceived stress (p < .001) scales. The attention control group also decreased scores on the depression (p < .01), trait anxiety (p < .001), and perceived stress (p < .01) scales. No significant differences were found between groups. Conclusions: Although the multibehavioral intervention was found to be effective in decreasing psychological CVD risk factors in older men, it was found only to be more effective than the attention control group in decreasing anger. Because anger was significantly higher in the experimental group at baseline, this finding might be attributed to lack of randomization at baseline. Implications: Research has substantiated the impact of negative emotions (depression, anxiety and anger) and stress on the development and exacerbation of cardiovascular disease. Clearly, a combination of exercise, nutrition and either stress management or health education has been found to significantly decrease CVD risk factors in older men. Nurses are in a unique position to educate their patients about the benefits of a multibehavioral approach to CVD risk factor reduction and the importance of the inclusion of psychological CVD factors in a risk factor reduction program.

Repository Posting Date:
26-Oct-2011
Date of Publication:
Jul-2002
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleThe Effectiveness of a Multibehavioral Intervention on Psychological CVD Risk Factors in Older Menen_GB
dc.identifier.urihttp://hdl.handle.net/10755/150735-
dc.description.abstract<table><tr><td colspan="2" class="item-title">The Effectiveness of a Multibehavioral Intervention on Psychological CVD Risk Factors in Older Men</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2002</td></tr><tr class="item-conference-date"><td class="label">Conference Date:</td><td class="value">July, 2002</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">McCrone, Susan</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">West Virginia University</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Associate Professor</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">smccrone@hsc.wvu.edu</td></tr><tr><td colspan="2" class="item-abstract">Objective: To determine the effectiveness of a multibehavioral intervention to decrease psychological cardiovascular disease (CVD) risk factors in older men. Design: A two group, pre - posttest quasi experimental design was used to test the hypothesis: Men in the multibehavioral intervention (exercise, nutrition and stress management) will experience a significantly greater reduction in psychological CVD risk factors than men in the attention control group (exercise, nutrition and health education). Population, Sample, Setting, Years: The population for the study was all men who had expressed interest in an exercise or nutrition program conducted by investigators at the facility. The convenience sample consisted of 32 men who had undergone baseline testing, met inclusion criteria and indicated that they would be available for a six - month intervention program. The study was conducted at an urban Veteran's Administration Medical Center in the mid-Atlantic region of the United States. Interventions: Both groups received the same exercise and nutrition components of the intervention. The exercise component consisted of an individually designed treadmill program that occurred at the facility twice a week for six months. The goal of the exercise program was to reach at least 70 % of the participant's heart rate reserve for at least 40 minutes. The nutrition component was taught by a research dietician in a one-hour classroom session for 12 weeks. Emphasis was on healthy eating not dieting. At the completion of the class, the multibehavioral group received 12 weeks of stress management class instruction taught by a doctorally prepared nurse. The stress management component was based on a cognitive behavioral social learning theory model. It targeted the interaction of the social environment with personality traits that predispose individuals to react to a situation in a particular way. Techniques included: monitoring of irrational thoughts, thought stopping, generating alternative interpretations of situations, assertiveness training, and time management. Participants were taught progressive muscle relaxation and given an audiotape to facilitate practice at home. The attention control group received 12 weeks of health education taught by the same nurse. Sessions included: cardiovascular risk, attaining a healthy lifestyle, time management and incorporating exercise. No stress management content was included. Outcome Variables: Depression - Geriatric Depression Scale, Anxiety - Spielberger State-Trait Anxiety Scale, Anger - Spielberger Anger Expression Scale, Stress - Perceived Stress Scale Methodology: Questionnaires were sent to 160 men and 120 were returned (80% return rate). Ninety men indicated that they would be interested in further testing and completed at least one baseline clinic visit, which included completion of the CES-D (a depression screening tool) and the Mini-Mental State Exam. Inclusion criteria included: over age 55, no recent MI or stroke, no current alcoholism, ability to exercise, score above 16 on the CES-D and score above 27 on the Mini-Mental State Exam. Of the men meeting inclusion criteria, 32 men indicated interest in a six-month intervention program and were assigned to groups based upon their availability. Findings: Of the 32 men beginning the study, 30 completed (6% attrition). Demographic characteristics of the sample included: mean age 66.4 years + 5.5 years, 100% Caucasian, 78% married, 76% some college and 62% retired. There were no significant between group differences on any demographic variable. Baseline analyses revealed group differences on anger in, and total anger scales with the experimental group scoring significantly higher. From pretest to posttest, the experimental group decreased scores on the depression (p &lt; .001), trait anxiety (p &lt; .001), total anger (p &lt; .05), and perceived stress (p &lt; .001) scales. The attention control group also decreased scores on the depression (p &lt; .01), trait anxiety (p &lt; .001), and perceived stress (p &lt; .01) scales. No significant differences were found between groups. Conclusions: Although the multibehavioral intervention was found to be effective in decreasing psychological CVD risk factors in older men, it was found only to be more effective than the attention control group in decreasing anger. Because anger was significantly higher in the experimental group at baseline, this finding might be attributed to lack of randomization at baseline. Implications: Research has substantiated the impact of negative emotions (depression, anxiety and anger) and stress on the development and exacerbation of cardiovascular disease. Clearly, a combination of exercise, nutrition and either stress management or health education has been found to significantly decrease CVD risk factors in older men. Nurses are in a unique position to educate their patients about the benefits of a multibehavioral approach to CVD risk factor reduction and the importance of the inclusion of psychological CVD factors in a risk factor reduction program.<br/><br/></td></tr></table>en_GB
dc.date.available2011-10-26T10:41:25Z-
dc.date.issued2002-07en_GB
dc.date.accessioned2011-10-26T10:41:25Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
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