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Changes in Functional Health Status of Older Women With Heart Disease

Evaluation of a Program Based on Self-Regulation

^a University of Michigan School of Public Health, Ann Arbor
^b Henry Ford Heart and Vascular Institute, Henry Ford Hospital, Detroit, Michigan
^c University of Michigan Hospitals, Ann Arbor

Noreen M. Clark, Marshall H. Becker Professor of Public Health, University of Michigan School of Public Health, 109 Observatory, Ann Arbor, MI 48109-2029 E-mail: nmclark{at}umich.edu.

Objectives. This study involving 570 women aged 60 years or older with heart disease, assessed the effects of a disease management program on physical functioning, symptom experience, and psychosocial status.

Methods. Women were randomly assigned to control or program groups. Six to eight women met weekly with a health educator and peer leader over 4 weeks to learn self-regulation skills with physical activity as the focus. Evaluative data were collected through telephone interviews, physical assessments, and medical records at baseline and 4 and 12 months post baseline.

Results. At 12 months, compared with controls, program women were less symptomatic ( p < .01), scored better on the physical dimension of the Sickness Impact Profile (SIP; p < 0.05), had improved ambulation as measured by the 6-minute walk ( p < 0.01), and lost more body weight ( p < .001). No differences related to psychosocial factors as measured by the SIP were noted.

Conclusion. A self-regulation-based program that was provided to older women with heart disease and that focused on physical activity and disease management problems salient to them, improved their physical functioning and symptom experience. Psychosocial benefit was not evident and may be a result of measurement error or due to insufficient program time spent on psychosocial aspects of functioning.

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