BMC Cardiovascular Disorders | |
A qualitative synthesis of factors influencing maintenance of lifestyle behaviour change in individuals with high cardiovascular risk | |
Allan House1  Kate Mary Hill1  Ana Claudia Bara1  Stephanie Honey1  Grania Fenton1  Jenni Murray1  | |
[1] Academic Unit of Psychiatry and Behavioural Sciences, Leeds Institute of Health Sciences, The University of Leeds, Charles Thackrah Building, 101 Clarendon Road, Leeds LS2 9LJ, UK | |
关键词: Maintenance; Primary health care; Secondary prevention; Primary prevention; Health behaviours; Lifestyle; Cardiovascular diseases; | |
Others : 857612 DOI : 10.1186/1471-2261-13-48 |
|
received in 2013-01-14, accepted in 2013-06-28, 发布年份 2013 | |
【 摘 要 】
Background
Management of cardiovascular risk factors includes commitment from patients to adhere to prescribed medications and adopt healthy lifestyles. Unfortunately many fail to take up and maintain the four key healthy behaviours (not smoking, having a balanced diet, limiting alcohol consumption and being more active). Five factors (beliefs, knowledge, transport and other costs, emotions, and friends and family support) are known to predict uptake of lifestyle behaviour change. The key factors influencing maintenance of healthy lifestyles are not known but would be helpful to support the development of relapse prevention programmes for this population. Our review aimed to clarify the main patient perceived factors thought to influence maintenance of changed healthy lifestyles.
Methods
We performed a systematic review of qualitative observational studies and applied the principles of content synthesis and thematic analysis to extract reported factors (barriers and facilitators) considered by individuals to be influential in maintaining changed healthy lifestyle behaviours. Factors were then organised into an existing framework of higher order categories which was followed by an analysis of the interrelationships between factors to identify key themes.
Results
Twenty two studies met our inclusion criteria. Participants reported barriers and facilitators within 13 categories, the majority of which were facilitators. The most commonly reported influences were those relating to social support (whether provided formally or informally), beliefs (about the self or the causes and management of poor health, and the value of maintaining lifestyle behaviours), and other psychological factors (including attitude, thinking and coping styles, and problem solving skills). Physical activity was the most commonly investigated behaviour in four categories, but overall, the main barriers and facilitators were related to a range of behaviours. Through analysis of the interrelationships between factors within categories, ‘social support’, ‘education and knowledge’, and ‘beliefs and emotions’ were all considered key themes.
Conclusions
Our review suggests that for the most part, factors that influence lifestyle change are also important for maintaining healthy behaviours. This indicates that addressing these barriers and facilitators within lifestyle support programmes would also be of value in the longer-term.
【 授权许可】
2013 Murray et al.; licensee BioMed Central Ltd.
【 预 览 】
Files | Size | Format | View |
---|---|---|---|
20140723082855473.pdf | 362KB | download | |
67KB | Image | download |
【 图 表 】
【 参考文献 】
- [1]Blair S: Physical inactivity: the biggest public health problem of the 21st century. Br J Sports Med 2009, 43:1-2.
- [2]Gillies C, Abrams K, Lambert P, Cooper N, Suton A, Hsu R, et al.: Pharmacological and lifestyle interventions to prevent or delay type 2 diabetes in people with impaired glucose tolerance: systematic review and meta-analysis. Br Med J 2007, 334(7588):299.
- [3]British Heart Foundation: The National Audit of Cardiac Rehabilitation. Annual Report. London: British Heart Foundation; 2012.
- [4]Tsai A, Wadden T: Systematic review: An evaluation of major commercial weight loss programs in the United States. Ann Intern Med 2005, 142:56-66.
- [5]Hughes J, Keely J, Naud S: Shape of the relapse curve and long-term abstinence among untreated smokers. Addiction 2004, 99:29-38.
- [6]Ferguson J, Bauld L, Chesterman J, Judge K: The English smoking treatment services: one year outcomes. Addiction 2005, 100(Suppl 2):59-69.
- [7]Curioni CC, Lourenco PM: Long-term weight loss after diet and exercise: a systematic review. Int J Obes 2005, 29:1168-1174.
- [8]Murray J, Hill K, Honey S, Craigs C, House A: Qualitative synthesis: factors affecting lifestyle change to reduce cardiovascular risk. Br J Gen Pract 2012, 61:296-297. (abridged text, in print at
- [9]Murray J, Craigs C, Hill K, Honey S, House A: A systematic review of patient reported factors associated with uptake and completion of cardiovascular lifestyle behaviour change. BMC Cardiovasc Disord 2012, 12:120. BioMed Central Full Text
- [10]Marlett GA, Gordon JR: Relapse prevention: Maintenance strategies in the treatment of addictive behaviours. New York: Guildford Press; 1985.
- [11]Perri M, Nezu A, Viegener B: Improving the long-term management of obesity: Theory, research and clinical guidelines. New York: Wiley; 1992.
- [12]Coleman T, Agboola S, Leonardi-Bee J, Taylor M, McEwen A, McNeill A: Relapse prevention in UK Stop Smoking Services: current practice, systematic reviews of effectiveness and cost-effectiveness analysis. Health Technol Assess 2010, 14:49.
- [13]Department of Health: Putting prevention first. Vascular checks: risk assessment and management. London: Department of Health; 2008.
- [14]Lim LS, Haq N, Mahmood S, Hoeksema L: Atherosclerotic cardiovascular disease screening in adults: American College of Preventive Medicine position statement on preventive practice. American Journal Preventative Medicine 2011, 40(381):e1-e10.
- [15]NVDPA: Australian Guidelines for the management of absolute cardiovascular disease (CVD) risk. Canberra: National Vascular Disease Prevention Alliance; 2012.
- [16]Brotons C, Bulc M, Sammut MR, Sheehan M, Manuel da Silva Martins C, Björkelund C, et al.: Attitudes toward preventive services and lifestyle: the views of primary care patients in Europe. The EURO PREVIEW patient study. Fam Pract 2012, 29(suppl 1):i168-i176.
- [17]Prochaska J, Di Clemente C: Stages and processes of self-change of smoking: toward an integrative model of change. J Consult Clin Psychol 1983, 51(3):390-395.
- [18]Hall RF, Joseph DH, Schwartz-Barcott D: Behavioral maintenance: a closer look. Nurs Forum 2002, 37(1):5-11.
- [19]Attebring MF, Hartford M, Hjalmarson A, Caidahl K, Karlsson T, Herlitz J: Smoking habits and predictors of continued smoking in patients with acute coronary syndromes. J Adv Nurs 2004, 46(6):614-623.
- [20]Barte JCM, ter-Bogt NCW, Bogers RP, Teixeira PJ, Blissmer B, Mori TA, et al.: Maintenance of weight loss after lifestyle interventions for overweight and obesity, a systematic review. Obes Rev 2010, 11(12):899-906.
- [21]Reid RD, Tulloch H, Kocourek J, Morrin LI, Beaton LJ, Papadakis S, et al.: Who will be active? Predicting exercise stage transitions after hospitalization for coronary artery disease. Can J Physiol Pharmacol 2007, 85(1):17-23.
- [22]Nelson KM, McFarland L, Reiber G: Factors influencing disease self-management among veterans with diabetes and poor glycemic control. J Gen Intern Med 2007, 22(4):442-447.
- [23]CRD: Systematic Reviews: CRD’s guidance for undertaking reviews in health care. York: Centre for Reviews and Dissemination, University of York; 2008.
- [24]Thomas J, Harden A: Methods for thematic analysis of qualitative research in systematic reviews. BMC Med Res Methodol 2008, 8:45. BioMed Central Full Text
- [25]Murray J, Hill K, Honey S, Craigs C, House A: Qualitative synthesis: factors affecting lifestyle change to reduce cardiovascular risk (abridged text). Br J Gen Pract 2012, 61:296-297.
- [26]Tong A, Sainsbury P, Craig J: Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care 2007, 19(6):349-357.
- [27]Long AF, Godfrey M: An evaluation tool to assess the quality of qualitative research studies. Int J Social Research Methodology 2004, 7(2):181-196.
- [28]Beverly EA, Wray LA: The role of collective efficacy in exercise adherence: a qualitative study of spousal support and type 2 diabetes management. Health Educ Res 2010, 25(2):211-223.
- [29]Bidgood J, Buckroyd J: An exploration of obese adults’ experience of attempting to lose weight and to maintain a reduced weight. Couns Psychother Res 2005, 5(3):221-229.
- [30]Byrne S, Cooper Z, Fairburn C: Weight maintenance and relapse in obesity: a qualitative study. Int J Obes Relat Metab Disord 2003, 27(8):955-962.
- [31]Chen K, Chen M, Lee S, Cho H, Weng L: Self-management behaviours for patients with chronic obstructive pulmonary disease: a qualitative study. J Adv Nurs 2008, 64(6):595-604.
- [32]Coghill N, Cooper AR: Motivators and de-motivators for adherence to a program of sustained walking. Prev Med 2009, 49(1):24-27.
- [33]Dailey R, Schwartz KL, Binienda J, Moorman J, Neale AV: Challenges in making therapeutic lifestyle changes among hypercholesterolemic African-American patients and their physicians. J Natl Med Assoc 2006, 98(12):1895-1903.
- [34]Darr A, Astin F, Atkin K: Causal attributions, lifestyle change, and coronary heart disease: illness beliefs of patients of South Asian and European origin living in the United Kingdom. Heart Lung 2008, 37(2):91-104.
- [35]Davis EM, Clark JM, Carrese JA, Gary TL, Cooper LA: Racial and socioeconomic differences in the weight-loss experiences of obese women. Am J Public Health 2005, 95(9):1539-1543.
- [36]Gazmararian JA, Ziemer DC, Barnes C: Perception of barriers to self-care management among diabetic patients. Diabetes Educ 2009, 35(5):778-788.
- [37]Gregory S, Bostock Y, Backett-Milburn K: Recovering from a heart attack: a qualitative study into lay experiences and the struggle to make lifestyle changes. Fam Pract 2005, 23(2):220-225.
- [38]Gulanick M, Bliley A, Perino B, Keough V: Recovery patterns and lifestyle changes after coronary angioplasty: the patient’s perspective. Heart Lung 1998, 27(4):253-262.
- [39]Lee L-L, Avis M, Arthur A: The role of self-efficacy in older people’s decisions to initiate and maintain regular walking as exercise - findings from a qualitative study. Prev Med 2007, 45(1):62-65.
- [40]Lewis R, Cramp F: Facilitators and barriers to exercise maintenance in chronic obstructive pulmonary disease: patient views. Physiotherapy Ireland 2010, 31(2):19-24.
- [41]Malpass A, Andrews R, Turner KM: Patient Perception, Preference and Participation: patients with Type 2 Diabetes experiences of making multiple lifestyle changes: a qualitative study. Patient Education and Counselling 2009, 74(2):258-263.
- [42]Nagelkerk J, Reick K, Meengs L: Perceived barriers and effective strategies to diabetes self-management. J Adv Nurs 2006, 54(2):151-158.
- [43]O’Shea SD, Taylor NF, Paratz JD: But watch out for the weather: factors affecting adherence to progressive resistance exercise for persons with COPD. J Mol Signal 2007, 27(3):166-174.
- [44]Parry O, Fowkes F, Thomson C: Accounts of quitting among older ex-smokers with smoking-related disease. J Health Psychol 2001, 6(5):481-493.
- [45]Peel E, Douglas M, Parry O, Lawton J: Type 2 diabetes and dog walking: patients’ longitudinal perspectives about implementing and sustaining physical activity. Br J Gen Pract 2010, 60(577):570-577.
- [46]Peterson JC, Allegrante JP, Pirraglia PA, Robbins L, Lane KP, Boschert KA, et al.: Living with heart disease after angioplasty: a qualitative study of patients who have been successful or unsuccessful in multiple behavior change. Heart Lung 2010, 39(2):105-115.
- [47]Rahim-Williams B: Beliefs, behaviors, and modifications of type 2 diabetes self-management among African American women. J Natl Med Assoc 2011, 103(3):203-215.
- [48]Sullivan ED, Joseph DH: Struggling with behavior changes: a special case for clients with diabetes. Diabetes Educ 1998, 24(1):72-77.
- [49]White S, Bissell P, Anderson C: Patients’ perspectives on cardiac rehabilitation, lifestyle change and taking medicines: implications for service development. J Health Serv Res Policy 2010, 15(Suppl 2):47-53.
- [50]White S, Bissell P, Anderson C: A qualitative study of cardiac rehabilitation patients’ perspectives on making dietary changes. J Hum Nutr Diet 2011, 24(2):122-127.
- [51]Jolly K, Lewis A, Beach J, Denley J, Adab P, Deeks J, et al.: Comparison of range of commercial or primary care led weight reduction programmes with minimal intervention control for weight loss in obesity: lighten-up randomised controlled trial. BMJ 2011, 343:d6500.
- [52]Malchodi CS, Oncken C, Dornelas EA, Caramanica L, Gregonis E, Curry SL: The effects of peer counselling on smoking cessation and reduction. Obstet Gynecol 2003, 101:504-510.
- [53]Hughes J, Todorovic V, Kemp H: ‘The Sugar Buddies’: An intervention programme for ‘obese’ patients with poorly controlled diabetes. J Hum Nutr Diet 1999, 12(SUPPL. 1):71-78.
- [54]Wing RR, Jeffery R: Benefits of recruiting participants with friends and increasing social support for weight loss and maintenance. J Consult Clin Psychol 1999, 1999(67):132-138.
- [55]Christakis NA, Fowler JF: The spread of obesity epidemic in a large social network over 32 years. N Engl J Med 2007, 357:370-379.
- [56]Bahr DB, Browning RC, Wyatt HR, Hill JO: Exploiting social networks to mitigate the obesity epidemic. Obesity 2009, 17(4):723-728.
- [57]Niknian M, McKinlay SM, Rakowski W, Carleton R: A comparison of perceived and objective CVD risk in a general population. Am J Public Health 1989, 79(12):1653-1654.
- [58]Hippisley-Cox J, Coupland C, Vinogradova Y, Robson J, Minhas R, Sheikh A, et al.: Predicting cardiovascular risk in England and Wales: prospective derivation and validation of QRISK2. Br Med J 2008, 336:a332.
- [59]D’Agostino RB, Vasan RS, Pencina M, Wolf P, Cobain M, Massaro J, et al.: General cardiovascular risk profile for use in primary care: The Framingham Heart Study. Circulation 2008, 117:743-753.
- [60]Zhang Y, Tuomilehto J, Jousilahti P, Wang Y, Hu G, Antikainen R: Lifestyle factors on the risks of ischemic and hemorrhagic stroke. Archives of Internal Medicine 2011, 171(20):1811-1818.
- [61]National Prescribing Centre: Statins patient decision aid. NHS, National Prescribing Centre; 2009. http://www.npc.nhs.uk/patient_decision_aids/pda.php webcite
- [62]Webster R, Heeley E: Perceptions of risk, understanding cardiovascular disease. Risk Management and Healthcare Policy 2010, 3:49-60.
- [63]Head S, Brookhart A: Lifestyle modification and relapse-prevention training during treatment for weight loss. Behav Ther 1997, 28(2):307-321.
- [64]Lee L-L, Avis M, Arthur A: The role of self-efficacy in older people’s decisions to initiate and maintain regular walking as exercise – Findings from a qualitative study. Prev Med 2007, 45(1):62-65.
- [65]Department of Health: Public Health England’s Operating Model. London: Department of Health; 2011.