2.50
Hdl Handle:
http://hdl.handle.net/10755/164174
Category:
Abstract
Type:
Presentation
Title:
Collaborative Intervention Improves Adherence in Cardiac Elders
Author(s):
Caroll, Diane L.; Rankin, Sally H.
Author Details:
Diane L. Carroll, PhD, APRN, BC, Massachusetts General Hospital, Boston, Massachusetts, USA, email: nacnsorg@nacns.org; Sally H. Rankin, PhD, RN, FAAN, University of California, San Francisco, California, USA
Abstract:
Purpose: We assessed the hypothesis that a randomized group of cardiac elders, coached by peer advisors (PA), would be significantly more likely to adhere to medical recommendations and less likely to be re-hospitalized than cardiac elders not assigned to the intervention group. Significance: Unmarried elders, over 65 years of age, lack in-home partner support and have poorer health outcomes post-MI and CABG than elders who are partnered. Provision of peer support from another elder who has suffered the same cardiac event may provide sufficient coaching and enhanced self-efficacy to improve adherence and decrease cardiac re- hospitalizations. Background/Design: Randomized clinical trial Methods: Unmarried patients (n= 247) were enrolled and randomized while hospitalized post-MI or CABG in 5 U.S. university medical centers. Subjects assigned to the treatment group were matched with another older person who had been trained by Advanced Practice Nurses (APNs) to be a PA. Data were collected at 6 weeks, 3 months, and 1 year after the cardiac event. Measures included the MOS General Adherence 5-item scale and questions pertaining to re-hospitalization. Data were analyzed using linear mixed model analyses and generalized estimation effects logistic regression. Findings: Subjects were 65% female; 61% were CABG patients; 80% were retired; 9% were minority; and mean age was 76 years (range=65-101). Subjects in the intervention group were significantly more likely to adhere to medical recommendations at 1 year after the cardiac event than the standard care group (p=.011). Although there were no statistically significant differences between the control and experimental groups for the re-hospitalization binary variable, more standard care subjects were re-hospitalized for complications at 6 months after the cardiac event than were intervention subjects. Conclusions: Unpartnered cardiac elders benefit from a low technology, low cost intervention by peer advisors even 9 months after conclusion of the intervention. However, the intervention does not appear to influence re-hospitalization rates. Implications for Practice: Peer support is an efficacious intervention for unpartnered cardiac elders.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2007
Conference Name:
CNS Outcomes: Ensuring Safety and Quality
Conference Host:
NACNS - National Association of Clinical Nurse Specialists
Conference Location:
Phoenix, Arizona, USA
Description:
Conference theme: CNS Outcomes: Ensuring Safety and Quality, held February 28-March 1 in Phoenix, Arizona, USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleCollaborative Intervention Improves Adherence in Cardiac Eldersen_GB
dc.contributor.authorCaroll, Diane L.en_US
dc.contributor.authorRankin, Sally H.en_US
dc.author.detailsDiane L. Carroll, PhD, APRN, BC, Massachusetts General Hospital, Boston, Massachusetts, USA, email: nacnsorg@nacns.org; Sally H. Rankin, PhD, RN, FAAN, University of California, San Francisco, California, USAen_US
dc.identifier.urihttp://hdl.handle.net/10755/164174-
dc.description.abstractPurpose: We assessed the hypothesis that a randomized group of cardiac elders, coached by peer advisors (PA), would be significantly more likely to adhere to medical recommendations and less likely to be re-hospitalized than cardiac elders not assigned to the intervention group. Significance: Unmarried elders, over 65 years of age, lack in-home partner support and have poorer health outcomes post-MI and CABG than elders who are partnered. Provision of peer support from another elder who has suffered the same cardiac event may provide sufficient coaching and enhanced self-efficacy to improve adherence and decrease cardiac re- hospitalizations. Background/Design: Randomized clinical trial Methods: Unmarried patients (n= 247) were enrolled and randomized while hospitalized post-MI or CABG in 5 U.S. university medical centers. Subjects assigned to the treatment group were matched with another older person who had been trained by Advanced Practice Nurses (APNs) to be a PA. Data were collected at 6 weeks, 3 months, and 1 year after the cardiac event. Measures included the MOS General Adherence 5-item scale and questions pertaining to re-hospitalization. Data were analyzed using linear mixed model analyses and generalized estimation effects logistic regression. Findings: Subjects were 65% female; 61% were CABG patients; 80% were retired; 9% were minority; and mean age was 76 years (range=65-101). Subjects in the intervention group were significantly more likely to adhere to medical recommendations at 1 year after the cardiac event than the standard care group (p=.011). Although there were no statistically significant differences between the control and experimental groups for the re-hospitalization binary variable, more standard care subjects were re-hospitalized for complications at 6 months after the cardiac event than were intervention subjects. Conclusions: Unpartnered cardiac elders benefit from a low technology, low cost intervention by peer advisors even 9 months after conclusion of the intervention. However, the intervention does not appear to influence re-hospitalization rates. Implications for Practice: Peer support is an efficacious intervention for unpartnered cardiac elders.en_GB
dc.date.available2011-10-27T11:43:25Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T11:43:25Z-
dc.conference.date2007en_US
dc.conference.nameCNS Outcomes: Ensuring Safety and Qualityen_US
dc.conference.hostNACNS - National Association of Clinical Nurse Specialistsen_US
dc.conference.locationPhoenix, Arizona, USAen_US
dc.descriptionConference theme: CNS Outcomes: Ensuring Safety and Quality, held February 28-March 1 in Phoenix, Arizona, USAen_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.en_US
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