论文部分内容阅读
Background: Despite dramatic decrease in coronary artery disease (CAD) of nearly 50% mortality reduction compared to 20 years ago, CAD is the leading cause of premature death in most European countries.Daily, 110 Swedes are struck by MI, 60% survive and live life-long with CAD.Although there is convincing evidence that life style changes, such as regular exercise and/or stop smoking, alters the course of events, risk factors remain e.g.17 % smoke and 51 % have elevated total serum cholesterol, 6 months after an event of CAD.Outcomes can improve if core components of secondary prevention programmes are pedagogically structurally and applied using adult learning.principles e.g.problem based learning (PBL).A pedagogy based on patients beliefs is a necessary requisite for effective patient learning.Until now, most education programs for patients with CAD lack involvement of their beliefs and are not based on adult learning principles.Pedagogical processes in health care seem to be unplanned and embedded in treatment; the goals are vague or non-existent.We therefore attempted to identify patients beliefs about lifestyle changes in order to incorporate this knowledge in a patient education programme based on PBL in primary health care (PHC).Methods/Design: A randomised controlled design was used in this pilot study that started in 2010 to be finished in November 2011Seventeen patients were included in the study and interviewed at baseline and there after randomised to experiment group (PBL-intervention) or control group (mailed patient information) and followed up after 2 months of intervention.A qualitative analysis of the interviews at baseline and after 2 months was carried out to be followed up after 1 year of intervention.Preliminary findings: Beliefs about lifestyle changes from the patients perspective were revealed.The disorderly body could restrain physical activity and the notion of that The years soiled the vessels felt comforting in regard to dietary changes when habits was hard to change.The belief ofWell-being despite bodily failure was an encouraging thought in the daily life.Living by The idea of the active human being and showing a Confidence to authorities implied that current health care discourses were impacting on the patients beliefs.Discussion: We expect that the 1-year PBL-patient education have impact on patients beliefs, to empower life style changes compared to 1-year of mailed patient information.The assumption is that PBL will reduce cardiovascular events in the long-term perspective compared to controls.Further, the obtained knowledge of this study can contribute to patients agency to handle life style changes and furthermore decrease the number of patients having another event of CAD in Sweden.