退伍军人心脏康复:一个叙事审查
Merilyn S Varghese1, Wen-Chih Wu, Kariann R Drwal
1Author Affiliations: VA Connecticut Healthcare System, West Haven, Connecticut (Drs Varghese, Burg, Gaffey, Brandt, Bastian, and Gandhi); Yale School of Medicine, New Haven, Connecticut (Drs Varghese, Burg, Gaffey, Brandt, Bastian, Gandhi); Providence VA Medical Center and the Miriam Hospital Cardiovascular Rehabilitation Center, Providence, Rhode Island (Dr Wu); Departments of Medicine, Epidemiology and Center for Global Cardiometabolic Health, Brown University, Providence, Rhode Island (Dr Wu); VA Office of Rural Health (ORH), Veterans Rural Health Resource Center-Iowa City, Iowa City VA Healthcare System, Iowa City, Iowa (Dr Drwal); The Center for Access and Delivery Research and Evaluation (CADRE) Iowa City VA Healthcare System, Iowa City, Iowa (Dr Drwal); Richard A. and Susan F. Smith Center for Outcomes Research, Beth Israel Deaconess Medical Center, Boston, Massachusetts (Dr Kazi); Harvard Medical School, Boston, Massachusetts (Dr Kazi); VA Central Western Massachusetts Healthcare System, Leeds, Massachusetts (Dr Mattocks); and University of Massachusetts Medical School, Worcester, Massachusetts (Dr Mattocks).
退伍军人参与心脏康复 (CR) 尽管有好处,但参与率很低. 基于家庭的CR显示出克服交通等障碍的承诺,改善心血管疾病二次预防的结果.
科学领域:
- 心脏病学 心脏病学
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
背景情况:
- 退伍军人患心血管疾病的风险更高.
- 退伍军人事务 (VA) 医疗保健系统为具有独特医疗需求的独特人群提供服务.
- 心脏康复 (CR) 对于这一群体的二次预防至关重要.
研究的目的:
- 审查现有关于CR利用和结果的数据,特别是在美国退伍军人中.
- 识别退伍军人人口中CR参与的挑战和促进者.
- 评估不同CR交付模式对退伍军人的有效性.
主要方法:
- 使用主要科学数据库 (PubMed,Scopus) 进行了全面的文献搜索.
- 关键词包括"心脏康复"和"美国退伍军人".
- 审查的重点是研究CR利用,障碍和退伍军人人口中的结果.
主要成果:
- 退伍军人可以通过VA医疗中心 (面对面或在家) 或社区中心访问CR.
- 参与率仍然很低,前往亲自CR的交通是很大的障碍.
- 基于家庭的CR成为一个有前途的替代方案,缓解运输问题,并在疫情期间证明具有弹性.
结论:
- 退伍军人中CR参与率低于最佳水平,尽管有证明的好处,如提高运动能力,减少抑郁症状和降低死亡率.
- 基于家庭的CR提供了一个可行的解决方案,以增加访问和克服参与障碍.
- 需要进一步研究CR吸收,心理健康影响,差异 (性别/种族) 和退伍军人的长期结果.
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