Objective

Communicating risk information and offering lifestyle advice are important goals in cardiac rehabilitation. However, the most effective way and the most effective source to communicate this information are not yet known. Therefore, we examined the effect of source (cardiologist, physiotherapist) and framing (gain, loss) of brief lifestyle advice on patients’ intention-to-change-lifestyle.

Methods

In an online experimental study, 636 cardiac patients (40% female, 67 (10) yrs.) were randomly assigned to one of four textual vignettes. Effect of source and framing on intention-to-change-lifestyle (assessed using a 5-point Likert scale) was analysed using analysis of covariance (ANCOVA).

Results

Patients expressed positive intention-to-change-lifestyle after receiving advice from the cardiologist (M = 4.1) and physiotherapist (M = 3.9). However, patients showed significantly higher intention-to-change-lifestyle after receiving advice from the cardiologist (0.58 [0.54–0.61]) when compared with the physiotherapist (0.52 [0.48–0.56]), (F[1,609] = 7.06, P = 0.01). Gain-framed and loss-framed advice appeared equally effective. However, communicating risks (loss) was remembered by only 9% of patients, whereas 89% remembered benefits (gain).

Conclusions

Our study shows the value of cardiologists and physiotherapists communicating brief lifestyle advice, as cardiac patients expressed positive intention for lifestyle change after receiving advice, irrespective of framing. Lifestyle advice should include benefits due to better recall.

中文翻译：

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心脏护理中的简短生活方式建议：信息来源和框架的实验研究

客观的

交流风险信息和提供生活方式建议是心脏康复的重要目标。然而，传达这些信息的最有效方式和最有效来源尚不清楚。因此，我们研究了简短生活方式建议的来源（心脏病专家、物理治疗师）和框架（获得、失去）对患者改变生活方式的意图的影响。

方法

在一项在线实验研究中，636 名心脏病患者（40% 为女性，67 (10) 岁）被随机分配到四个文本插图之一。使用协方差分析 (ANCOVA) 分析来源和框架对改变生活方式的意图的影响（使用 5 点李克特量表评估）。

结果

在接受心脏病专家（ M  = 4.1）和物理治疗师（M  = 3.9）的建议后，患者表达了改变生活方式的积极意愿。然而，与物理治疗师 (0.52 [0.48–0.56]) 相比，接受心脏病专家建议 (0.58 [0.54–0.61]) 的患者表现出明显更高的改变生活方式的意愿，( F [1,609] = 7.06，P  = 0.01）。收益框架和损失框架的建议似乎同样有效。然而，只有 9% 的患者记得沟通风险（损失），而 89% 的患者记得好处（收益）。

结论

我们的研究显示了心脏病专家和物理治疗师传达简短的生活方式建议的价值，因为心脏病患者在接受建议后表达了改变生活方式的积极意愿，无论框架如何。生活方式建议应包括更好的记忆力带来的好处。