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Contact

Anne Michel

Dr. med. Sabine Stamm-Balderjahn

 

Charité – Universitätsmedizin Berlin

Institut für Medizinische Soziologie und Rehabilitations-

wissenschaft, Bereich Rehabilitationsforschung

Luisenstraße 13 A, 10117 Berlin

Tel.: 030 450 517 109

Fax: 030 450 517 932

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Effectiveness of a cross-sector gender-specific intervention to improve the health behaviour of CHD rehabilitees in phase III rehabilitation (CARO-PRE-II)

Project leader:

Prof. Dr. Karla Spyra

 

Project running time:

01.01.2011-31.03.2015

 

Background

Target agreements which are made between rehab physicians and rehabilitees at the end of the rehab measure with regard to a changed health behaviour should contribute to consolidating the achieved successes in the long term. Particular importance in this research plan is attached to the differing needs and expectations of women and men. The aim of the project is to develop and evaluate a cross-sector, gender-specific intervention for CHD rehabilitees which should contribute to improving and consolidating a health-conducive behaviour.

 

Methods

The study design consists of a randomised controlled intervention study with four measurement time points and an exploratory preliminary study. Included in each case are 280 female and male rehabilitees with the following diagnoses: acute coronary syndrome (ACS), bypass operation (ACB) or elective percutaneous coronary intervention (PCI):

 

Study design

With the help of group discussions and guideline-based interviews which were conducted with rehabilitees as well as experts from rehab research and practice, the aim is to identify and describe specific expectations and cognitions of female CHD rehabilitees with respect to a sustainable health behaviour. Building on this, a gender-specific intervention will be developed which plans a manual-based target agreement dialogue between rehab physicians and rehabilitees at the end of rehabilitation as well as a manual-based target control intervention between therapists (e.g. psychologists) and rehabilitees three months after the end of rehabilitation. The target control will take place in gender-separated small groups in the rehab clinic. The clinic personnel involved in the study (physicians and therapists) receive in advance, besides a project introduction, a content-based introduction to the HAPA model [1], which serves as the theoretical foundation for depicting health-relevant actions. Written surveys take place at the beginning and end of rehabilitation (T1/T2) as well as 6 and 12 months after rehab (T3/T4). Behavioural data are also measured (physical activity, nicotine consumption, nutrition, medication adherence and emotional well-being) as well as psychological constructs which are based on the HAPA model (e.g. self-efficacy expectations, action outcome expectations and action planning). At the end of the recruitment phase, in the participating establishments, selected process data of the rehabilitees included in the study will be measured (e.g. diagnoses, weight, cholesterol, blood sugar, blood pressure, medication). For the concept to be evaluated, structured manuals for physicians and therapists, gender-specific information for patients and their families as well as documents for goal achievement for health behaviour in phase III rehabilitation will be developed.

 

Current status of the project

40 guideline-based interviews with patients have been carried out (10 female and 10 male rehabilitees at the end of rehab and 2 months afterwards) as well as 5 expert interviews and 4 group discussions with rehabilitees. The evaluation took place in a theme-specific manner in terms of the content analytical method of Mayring (2008) with the aid of the software MAXQDA10.

 

The results of the qualitative preliminary study show tendencies which serve as the basis for the development of the gender-specific intervention. The different needs of male and female rehabilitees have to be taken into account in a more targeted manner. Male rehabilitees require concrete support in the areas of nutrition and relaxation. Moreover, it appears to be important to discuss with them concrete action steps for goal achievement. Female rehabilitees require concrete support with regard to their physical activity. The target setting refers here primarily to the participation in group-based activities (e.g. heart group, IRENA). In particular, individual possibilities to be physically active have to be developed together with female rehabilitees. The instruments used for the intervention (patient information, patient passport, family member information, questionnaires, target agreement documents) was developed in terms of the results and tested in a feasibility phase (N=72). The main phase began in May 2012.

 

Conference/Congress contributions

 

Cooperating rehabilitation establishments

 

Literature

 

The study is registered in the German Register of Clinical Studies (DRKS00003568).
(http://apps.who.int/trialsearch/)

 

[1] HAPA stands for Health Action Process Approach, a socio-cognitive model of health behaviour (Schwarzer, R.: 1992, 2001, 2002), which serves as the theoretical foundation of the intervention.




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