A nurse-led cardiac rehabilitation programme improves health behaviours and cardiac physiological risk parameters: evidence from Chengdu, China

J Clin Nurs. 2007 Oct;16(10):1886-97. doi: 10.1111/j.1365-2702.2007.01838.x.


Aim: The aim of this study was to examine the effect of a cardiac rehabilitation programme on health behaviours and physiological risk parameters in patients with coronary heart disease in Chengdu, China.

Background: Epidemiological studies indicate a dose-, level- and duration-dependent relationship exists between cardiac behavioural and physiological risks and coronary heart disease incidence as well as subsequent cardiac morbidity and mortality. Cardiac risk factor modification has become the very primary goal of modern cardiac rehabilitation programmes.

Design methods: A randomized controlled trial was conducted. Coronary heart disease patients (n = 167) who met the sampling criteria in two tertiary medical centres in Chengdu, south-west China, were randomly assigned to either an intervention group (the cardiac rehabilitation programme) or control group (the routine care). The change of health behaviours (walking performance, step II diet adherence, medication adherence, smoking cessation) and physiological risk parameters (serum lipids, blood pressure, body weight) were assessed to evaluate the programme effect.

Results: Patients in the intervention group demonstrated a significantly better performance in walking, step II diet adherence, medication adherence; a significantly greater reduction in serum lipids including triglyceride, total cholesterol, low-density lipoprotein; and significantly better control of systolic and diastolic blood pressure at three months. The majority of these positive impacts were maintained at six months. The effect of the programme on smoking cessation, body weight, serum high-density lipoprotein, was not confirmed.

Conclusions: A cardiac rehabilitation programme led by a nurse can significantly improve the health behaviours and cardiac physiological risk parameters in coronary heart disease patients. Nurses can fill significant treatment gaps in the risk factor management of patients with coronary heart disease.

Relevance to clinical practice: This study raises attention regarding the important roles nurses can play in cardiac rehabilitation and the unique way for nurses to meet the rehabilitative care needs of coronary heart disease patients. Furthermore, the hospital-home bridging nature of the programme also created a model for interfacing the acute care and community rehabilitative care.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aftercare / organization & administration
  • China
  • Exercise
  • Feeding Behavior
  • Female
  • Health Behavior*
  • Heart Diseases / etiology
  • Heart Diseases / psychology
  • Heart Diseases / rehabilitation*
  • Home Care Services, Hospital-Based / organization & administration*
  • Humans
  • Hyperlipidemias / complications
  • Hyperlipidemias / prevention & control
  • Hypertension / complications
  • Hypertension / prevention & control
  • Male
  • Middle Aged
  • Nurse's Role* / psychology
  • Nursing Evaluation Research
  • Obesity / complications
  • Obesity / prevention & control
  • Patient Compliance / psychology
  • Patient Education as Topic / organization & administration*
  • Program Evaluation
  • Risk Reduction Behavior*
  • Single-Blind Method
  • Smoking Cessation
  • Telephone