A Pilot Study of APN-led Self-management Program to Improve Cardiovascular Health Status among Korean Women with Risk Factors

Nah-Mee Shin; Nah-Mee Shin; Ji-Won Yoon; Jiwon Choi; Younghee Park; Songi Jeon

doi:10.7469/kjan.2016.28.2.237

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Shin, Shin, Yoon, Choi, Park, and Jeon: A Pilot Study of APN-led Self-management Program to Improve Cardiovascular Health Status among Korean Women with Risk Factors

Original Article

Korean J Adult Nurs 2016;28(2):237-245.

Published online: April 2016

DOI: https://doi.org/10.7469/kjan.2016.28.2.237

A Pilot Study of APN-led Self-management Program to Improve Cardiovascular Health Status among Korean Women with Risk Factors

Nah-Mee Shin¹, Nah-Mee Shin¹, Ji-Won Yoon², Jiwon Choi³, Younghee Park⁴, Songi Jeon¹

^¹College of Nursing, Korea University, Seoul

^²College of Nursing, Shinhan University, Dongducheon

^³School of Nursing, University of California, San Francisco

^⁴Department of Nursing, College of Medicine, Dongguk University, Gyeongju, Korea

Corresponding author: Shin, Nah-Mee College of Nursing, Korea University, 145 Anam-ro, Seongbuk-gu, Seoul 02841, Korea. Tel: +82-3290-4924, Fax: +82-927-4676, E-mail: nshin@korea.ac.kr

Received 16 March 201611 April 2016 Accepted 18 April 2016

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The aim of this study was to examine the effects of an Advanced Practice Nurse (APN)-led self-management program on cardiovascular health status among Korean women at risk of developing or progressing cardiovascular disease.

Methods

This pilot study used one-group pre- and post- test experimental design. At health fairs in a community, 30 women who had one or more risk factors for metabolic syndrome were recruited and agreed to participate in the study. A total of 25 women completed the study. The intervention consisted of weekly follow-up calls and self-monitoring diary after an hour of individual counseling regarding risk factors, fast walking, and healthy diet tailored to the participants’ needs. Physical activity was assessed with the World Health Organization International Physical Activity Questionnaire and a pedometer.

Results

Participants showed statistically significant improvements in blood pressure, body mass index, levels of triglyceride, total cholesterol and low density lipoprotein, numbers of metabolic syndrome factors, and the 10-year CV risk estimate after one month of concentrated intervention. In addition, their physical activity behavior significantly improved after the intervention.

Conclusion

This APN-led self-management program targeting modifiable risk factors by offering tailored counseling and concentrated support during the transition might be effective in preventing progression to the cardiovascular disease.

Keywords: Cardiovascular disease, Diet, Physical activity, APN, Metabolic syndrome

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Table 1.

Participants’ Characteristics (N=25)

Characteristics	Categories	n(%)
Age (year)	41~50	1 (4.0)
	51~60	7 (28.0)
	61~70	11 (44.0)
	71~80	6 (24.0)
Marital status	Married	16 (64.0)
Marital status	Widowed Divorced or separated	6 3 (24.0) (12.0)
Job	Full time homemaker Retired	16 2 (64.0) (8.0)
	Part time (hourly)	3 (12.0)
	Part time or full time	4 (16.0)
Highest education completed	Elementary	6 (24.0)
	Junior high	6 (24.0)
	High school	7 (28.0)
	≥Community college	6 (24.0)
Monthly household income (10,000 won)	＜200 (＜$1,700.00) ≥200 (≥$1,700.00)	18 7 (72.0) (28.0)
Post-menopause	Yes No	21 4 (84.0) (16.0)
Family history of CVD	Yes No	9 16 (36.0) (64.0)
Past medical history	Hypertension	6 (24.0)
	Hypercholesterolemia	9 (36.0)
	Diabetes Mellitus	1 (4.0)
Smoking	Yes	3 (12.0)
Smoking	Never	22 (88.0)
Regular exercise	Yes (3 days/week)	5 (20.0)
	Irregular (1~2 days/week)	6 (24.0)
	No	14 (56.0)

CVD=cardiovascular disease.

Table 2.

Cardiovascular Health Status, Physical Activity, and Diet at Time 1 and Time 2 (N=25)

Variables	Categories (normal range)	Time 1	Time 2	t	p
Variables	Categories (normal range)	M±SD	M±SD	t	p
Blood pressure (mmHg)	Systolic (＜140)	126.76±17.16	118.76±13.14	2.52	.019
Blood pressure (mmHg)	Diastolic (＜90)	75.20±11.54	69.80±6.34	2.82	.009
Obesity indicators	Body mass index (＜25 kg/m²)	25.14±3.52^†	24.85±3.44^†	3.63	.001
Obesity indicators	Waist circumference (＜85 cm)	82.12±7.66	81.54±7.70	1.61	.120
Blood cholesterol profile (mg/dL)	Total cholesterol (＜200)	212.10±34.01^†	201.35±36.09^†	2.51	.021
	High-density lipoprotein (＞50)	54.40±13.67	54.96±12.05	0.35	.727
	Low-density lipoprotein (＜130)	108.25±24.93	101.20±24.39	2.22	.039
	Triglycerides (＜150)	171.68±71.85^†	138.92±60.02	2.45	.022
Fasting blood glucose (＜100 mg/dL)		101.44±18.56^†	100.84±15.21^†	0.17	.870
Number of metabolic syndrome factors (＜3)		2.20±1.35	1.32±1.11	3.38	.002
Probability of 10-year risk estimate (%)		3.84±2.82	2.80±2.08	2.36	.027
Dietary habit	Level of fat intake	2.15±0.54	2.11±0.47	0.32	.750
Dietary habit	Level of sodium intake	2.17±0.37	2.07±0.39	2.22	.036
Physical activity (WHO IPAQ)	Days of walking for≥10 minutes	4.33±2.33	6.17±1.40	-3.73	.001
	Minutes of walking per day	62.86±39.17	100.00±134.56	-1.31	.205
	Minutes of physical inactivity per day	327.67±190.10	229.60±150.40	2.09	.048

^† Means higher than normal range.

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