Cardiac Rehabilitation 2011 Update for Primary Care Providers心脏康复2011更新初级保健提供者.ppt

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2018-03-30 发布于湖北
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Cardiac Rehabilitation 2011 Update for Primary Care Providers心脏康复2011更新初级保健提供者.ppt

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Cardiac Rehabilitation 2011 Update for Primary Care Providers心脏康复2011更新初级保健提供者

Cardiac Rehabilitation 2011Update for Primary Care Providers Douglass A Morrison, MD, PhD Cardiac Rehabilitation, Medical Director Yakima Regional and Yakima Valley Memorial Hospitals * Rehabilitation To restore to good health or useful life, through therapy and education. Changing our own behavior, for better health * Changing BehaviorResistances Therapy: connotation of ‘mental illness’ Rehabilitation: connotation of ‘substance abuse’ Personal Responsibility is much more difficult than blaming No one can rehabilitate another; most of the work is done by the patient, for himself.. * Active versus PassiveSecond Person versus First Person It is easier to tell others how they should change, than to change ourselves: empathy * Cardiac Rehabilitation 2011Bill of Fare What is cardiac rehabilitation? What is the difference between primary and secondary prevention? Is there good clinical evidence which supports the efficacy of cardiac rehabilitation? Survival Myocardial infarct (MI) reduction Stroke (CVA) prevention Avoidance of subsequent bypass surgery (CABG) Reduced repeat stenting (PCI) Reduced frequency of hospitalization * Cardiac Rehabilitation 2011Bill of Fare (2) 4. Does the evidence, which supports the use of cardiac rehabilitation apply: In the ‘reperfusion-era’ of post MI care? To the elderly (Medicare population)? Women? Care-givers, themselves? 5. In your personal, and professional experience, is behavior change: Easy, i.e. a ‘slam-dunk’? Impossible, and therefore, not even worth discussing Possible, but requiring sustained effort * Definition of Cardiac Rehabilitation A multi-component intervention, which is designed to: Optimize a cardiac patients physical, psychological and social function, and Stabilize, slow, or even reverse the underlying atherosclerosis; thereby Reducing the morbidity and mortality of coronary artery disease (CAD). * Physical Activity and the Prevention of Coronary Heart Disease Meta-analysis of 43 studies from world