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Biomedical subjects

Shirley M Moore

Publications and source records attributed to Shirley M Moore.

12 recordsLinked to original sources
PubMed2006

Predictors of health promotion behavior in women without prior history of coronary heart disease.

The purpose of this study was to determine health promotion behavior (HPB) and the best predictors of HPB in women without prior history of coronary heart disease (CHD). The sample included 119 women aged between 35 and 60 years who had no prior CHD history. The women were asked to complete a self-administered survey regarding their demographic data, personal CHD risk factors, HPB, CHD knowledge, and perceived benefits and barriers to CHD risk factor modification. The women in this study did not practice HPB regularly and had low CHD knowledge levels, a high perception level of benefits, and a moderate level of perceived barriers to CHD risk modification. Backward multiple regression analysis demonstrated that smoking history, family history of CHD, CHD knowledge levels, and perceived barriers to CHD risk modification were the best predictors of HPB in women without CHD. Women with fewer perceived barriers to CHD risk modification, higher CHD knowledge levels, and no smoking history or family history of CHD were more likely to practice HPB.

Adult↗
PubMed2006

Predictors of poor coronary heart disease knowledge level in women without prior coronary heart disease.

PURPOSE: The purpose of this study was to measure coronary heart disease (CHD) knowledge levels in women without a history of CHD and to determine predictors of poor CHD knowledge in these women. DATA SOURCES: The sample included 120 women between the ages of 35 and 60, who had no CHD history. Women were asked to complete self-administered surveys including demographic data, personal CHD risk factors, and a CHD Knowledge Test. CONCLUSIONS: Women lack CHD knowledge. Low educational level, normal serum lipids, high body mass index (BMI), and lack of access to a nurse practitioner (NP) were predictors of poor CHD knowledge levels in women without CHD history. IMPLICATIONS FOR PRACTICE: Women who had access to an NP were more likely to have higher CHD knowledge. In an attempt to decrease the morbidity and mortality associated with CHD, NPs may be able to improve CHD knowledge in women, particularly in those with lower educational level, normal serum lipids and higher BMI.

Adult↗
PubMed2006

Effects of a CHANGE intervention to increase exercise maintenance following cardiac events.

BACKGROUND: Despite participation in a cardiac rehabilitation program, there is a downward trajectory of exercise participation during the year following a cardiac event. PURPOSE: The purpose of this study was to test the effectiveness of CHANGE (Change Habits by Applying New Goals and Experiences), a lifestyle modification program designed to increase exercise maintenance in the year following a cardiac rehabilitation program. The CHANGE intervention consists of 5 small-group cognitive-behavioral change counseling sessions in which participants are taught self-efficacy enhancement, problem-solving skills, and relapse prevention strategies to address exercise maintenance problems. METHOD: Participants (N = 250) were randomly assigned to the CHANGE intervention (supplemental to usual care) or a usual-care-only group. Exercise was measured using portable wristwatch heart rate monitors worn during exercise for 1 year. Cox proportional hazards regression was used to determine differences in exercise over the study year between the study groups. RESULTS: Participants in the usual-care group were 76% more likely than those in the CHANGE group to stop exercising during the year following a cardiac rehabilitation program (hazard ratio = 1.76, 95% confidence interval = 1.08-2.86, p = .02) when adjusting for the significant covariates race, gender, comorbidity, muscle and joint pain, and baseline motivation. Most participants, however, had less than recommended levels of exercise amount and intensity. CONCLUSIONS: Counseling interventions that use contemporary behavior change strategies, such as the CHANGE intervention, can reduce the number of individuals who do not exercise following cardiac events.

Adult↗
PubMed2006

Older adults' views of cardiac rehabilitation program: is it time to reinvent?

In spite of the documented benefits of cardiac rehabilitation program (CRP) participation, older adults are not likely to participate. Older adults' expectations of and experiences with CRPs are not known. It is also not known whether women and men differ in their expectations and experiences. This descriptive study used a convenience sample of 40 older adults who had experienced an acute cardiac event to identify patients' views of CRPs. Focus groups revealed that older adults do not have an accurate understanding of what to expect in CRPs, and that older adults' experiences in CRPs were generally positive. Older adults suggested CRPs could be improved by including more socialization opportunities, offering varied forms of exercise, enhancing teaching about stress management, and adapting teaching strategies. In this study, "strength of physician referral" was identified as the main reason for participating or not participating in a CRP. Older men feared physical pain with exercise and older women expressed a need for emotional support. A major finding in this study was the report of adverse events (i.e., exhaustion, collapse) during exercise experienced by individuals who did not go to a CRP. Because the majority of adults participating in CRPs are older, transforming CRPs to meet the needs of these older adults is important. Future research on the effectiveness of alternative CRP models will provide evidence to ensure the delivery of quality, cost-effective care.

Acute Disease↗
PubMed2002

Using the CHANGE intervention to enhance long-term exercise.

Although Phase II Cardiac Rehabilitation (CR) is effective at reconditioning people following cardiac events, it has had limited effectiveness in assisting participants to maintain the long-term exercise necessary for secondary prevention of cardiovascular events. This article describes a promising new intervention, CHANGE (Change Habits by Applying New Goals and Experiences), designed to enhance individuals' problem solving, self-efficacy, and relapse prevention skills regarding long-term exercise. Five small-group, nurse-led sessions are used to provide the intervention during the last three weeks of the formal CR program, and at one and two months following CR. Pilot data indicate that the CHANGE intervention has a positive effect on number and length of exercise sessions, number of minutes exercised, and time spent in target heart rate (HR) zone as measured by wristwatch HR monitors for three months following CR. The CHANGE intervention was found to be acceptable to clients and feasible to clinicians.

Analysis of Variance↗
PubMedDate not supplied

Promoting health behavior change using appreciative inquiry: moving from deficit models to affirmation models of care.

This article describes a new theoretical approach to health promotion and behavior change that may be especially suited to underserved women. Appreciative inquiry (AI), an organizational development process that focuses on the positive and creative as a force for an improved future, is described and adapted for use as an intervention to achieve health behavior change at the individual level. Guiding principles for its use with clients are provided, and an example of its application is illustrated in a hypothetical case study of an African American woman of low-socioeconomic resources who is attempting to increase lifestyle exercise following a cardiac event. AI is contrasted with the more traditional problem-solving approaches to the provision of care. The advantages, challenges, and issues associated with the use of AI as a health behavior change strategy are discussed.

Black or African American↗
PubMedDate not supplied

Predictors of women's exercise maintenance after cardiac rehabilitation.

PURPOSE: Less than 50% of persons who participate in cardiac rehabilitation (CR) programs maintain an exercise regimen for as long as 6 months after completion. This study was conducted to identify factors that predict women's exercise following completion of a CR program. METHODS: In this prospective, descriptive study, a convenience sample of 60 women were recruited at completion of a phase II CR program. Exercise was measured using a heart rate wristwatch monitor over 3 months. Predictor variables collected at the time of the subjects' enrollment were age, body mass index, cardiac functional status, comorbidity, muscle or joint pain, motivation, mood state, social support, self-efficacy, perceived benefits or barriers, and prior exercise. RESULTS: Of women, 25% did not exercise at all following completion of a CR program and only 48% of the subjects were exercising at 3 months. Different predictors were found of the various dimensions of exercise maintenance. Predictors of exercise frequency were comorbidity and instrumental social support. Instrumental social support was the only predictor of exercise persistence. Comorbidity was the only predictor of exercise intensity. The only predictor of the total amount of exercise was benefits or barriers. CONCLUSIONS: Interventions aimed at increasing women's exercise should focus on increasing their problem-solving abilities to reduce barriers to exercise and increase social support by family and friends. Because comorbidity was a significant predictor of exercise, women should be encouraged to use exercise techniques that reduce impact on muscles and joints (eg, swimming) or exercising for short periods several times a day.

Adult↗
PubMedDate not supplied

Effects of cardiac rehabilitation on the recovery outcomes of older adults after coronary artery bypass surgery.

PURPOSE: This study aimed to examine differences in lower extremity function as well as perception of physical and mental function between adults 70 years of age or older who participated in a phase 2 cardiac rehabilitation program (CRP) (n = 32) and those who did not participate in a CRP (n = 33) after coronary artery bypass surgery (CABS). METHODS: In this two-group longitudinal comparative study, recovery outcomes measured at baseline (6 weeks) and 6 months after CABS were compared between older adults who participated and those who did not participate in a CRP. RESULTS: In study groups that were equivalent before the CRP, analysis of covariance (controlling for baseline scores) showed that 6 months after hospital discharge, those who participated in a CRP had greater lower extremity strength (F = 3.9; P =.04), greater ankle range of motion (F = 4.2; P =.02), better dynamic balance (F = 8.2; P =.003), better static balance (F = 3.3; P =.04), better gait (F = 4.7; P =.02), and perceptions of better physical function (F = 14.8; P =.00). The results remained the same when control was used for the effects of social support, self-efficacy, depression, comorbidity, cardiac functional status, and gender for all the variables except static balance. No difference related to perception of mental function was found between the study groups (F =.10; P =. 74). CONCLUSIONS: Participation in a CRP by older individuals improves lower extremity function (an important dimension in preventing disability) and perception of physical function. Cardiac rehabilitation programs can be used to optimize the recovery outcomes of older individuals after CABS.

Aged↗
PubMedDate not supplied

A model for economic analysis.

The production process model is proposed as a way to guide economic evaluation of health care projects, programs, technology, or research. The model is illustrated with data from the development of a home care computer intervention.

Cost-Benefit Analysis↗
PubMedDate not supplied

Designing and testing telehealth interventions to improve outcomes for cardiovascular patients.

This article presents considerations for the design and testing of electronic interventions to improve recovery outcomes in cardiac patients. A brief description of the design and testing of 2 telehealth interventions for cardiac patients is provided: HeartCare and E-CHANGE. The HeartCare project was a randomized trial of a home support program for patients after coronary artery bypass graft surgery. E-CHANGE is an Internet-based home support program designed to increase lifestyle exercise after a cardiac event. Lessons learned from these 2 projects regarding design considerations, system use, effectiveness, and research challenges are discussed. Methods to promote the preservation of nursing values in electronic systems are described, as well nursing roles in the use of computer-assisted care.

Coronary Artery Bypass↗