engleski

Shared decision making in lifestyle and nutrition for intervention in women with risk factors in cardiovascular health

Introduction: Cardiovascular diseases (CDV) are the leading cause of death for women in industrialized countries. The aim of our study was to determine the impact physicians’ interventions have on women’s decisional conflict surrounding lifestyle changes necessary to minimize CDV risks. Methods: This prospective, interventional pilot study included 76 women between 45 and 60 years with different reproductive status and one or more of cardiovascular risk factors: overweight or obese, high cholesterol, tobacco exposure, and high blood pressure. Prior and post the educational intervention, which included a lecture on life style and diet habits associated with CDV, as well as individually tailored decision aids accompanied with calculated 10-year CDV risk ; we measured decisional conflict (DC), state hope (IHS) and participants knowledge of CDV and lifestyle changes associated risks and benefits. Results: So far, the pilot included 76 women, aged 51.4±4.1, whose CDV risk ranged from 0.5 to 19.7 (M=5.2, SD=4.5). Their DC score significantly decreased after the intervention (M1=35, 95%CI 28-41 vs. M2=20, 95%CI 16-25 ; P<0.001 paired samples t-test), while their hope remained unchanged (M1=99, 95%CI 91-106 vs. M2=103, 95%CI 96-110 ; P=0.08, paired samples t-test). Most women (n=18, 86%) expressed willingness to change their life habits, 2 (9%) remained undecided, and 1 (5%) decided against making lifestyle changes. Discussion: Detection, treatment and life style interventions are meant to reduce major risk factors and instances of cardiovascular diseases. Although our individually tailored intervention lowered the decisional conflict of women regarding their necessary lifestyle changes for reducing CDV risks, their hope of actually reducing them remained the same. Conclusion: Intervention of primary care physicians is an effective first step for inducing lifestyle changes needed to decrease cardiovascular risks. With the continuing of our study we aim to find if such interventions will lead to actual behavior and risk change.

cardiovascular health; risk factors; life style; nutrition; women

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