Effect of a motivational intervention of obesity upon cardiovascular risk factors.
DOI:
https://doi.org/10.19230/jonnpr.2016.1.2.974Keywords:
Blood glucose, Cholesterol, Blood pressure, Motivational intervention.Abstract
Objective: To determine the effect on cardiovascular risk factors in a group of motivational intervention by nurses trained by an expert
psychologist, complementarily to the usual procedure.
Methods: Multicenter intervention in overweight and obese patients randomized clinical trial. Randomization of intervention by Basic
Health Zones (ZBS).Two groups located in separated different centers, one receiving motivational intervention in group (study group)
and the other routine monitoring (control group) were established. Variables: Sociodemographic, results: percentage of patients
reducing 5% of weight, assessment of cardiovascular risk factors and analytical data.
Results: 696 patients were evaluated; 377 control and 319 of the study group. Weight diminished in both groups in each visit. Mean
percent weight reduction remained at 1% in the control group and 2.5% in the intervention group (p-value = 0.009). 55.8% of patients
reduced their weight in the control group and 65.5% in the study group (p-value = 0.0391). 18.1% of patients in the control group
reduced more than 5% of weight; this percentage increased to 26.9% in the intervention group being statistically significant (p-value = 0.0304). No significant differences (5% vs. 8%) were detected at 2 years in the case of the 10% target. It was found after two years that BMI was reduced an average 0.9 kg / m2 in the control group and 2.4 kg / m2 in the study group (p-value = 0.0237). A significant evolution in triglycerides reduction and systolic blood pressure was detected. However there was no statistically significant reduction in blood sugar, diastolic blood pressure and other lipid parameters (total cholesterol, HDL and LDL-cholesterol).
Downloads
References
Obesity: preventing and managing the global epidemic. Report of a WHO consultation. Technical report series n.º
Geneva WHO, 2000.
NIH. National Institutes of Health. National Heart, Lung and Blood Institute. Clinical Guidelines on the
identification, evaluation and treatment of overweight and obesity in adults. The evidence report. Bethesda, 1999.
Sahuquillo Martínez A, Solera Albero J, Rodríguez Montes JA, Celada Rodríguez A, Tárraga Marcos ML, Torres
Moreno P, Tárraga López PJ. Alteración de los parámetros hepáticos en la esteatosis hepática no alcohólica de
pacientes con síndrome metabólico. JONNPR. 2016;1(1):19-24. DOI: 10.19230/jonnpr.2016.1.1.929
Bonow R, and Eckel R. Diet, obesity, and cardiovascular risk. N. Engl. J. Med,May 22,2003 348;21
Ridker P, Stampfer M, and Rifai N. Novel Risk factors for syhstemic atherosclerosis. A comparison of ©-reactive
protein, fibrinogen, homocysteine, lipoprotein (a), and standard cholester screenin as predictors of peripheral
arterial disease. JAMA, may 16, 2001-vol. 285
Cañizo F.J., Aguilar M, Carral F., Conget I., Costa A, Esteve E. Et al. Diabetes Mellitus tipo 2 y factores de riesgo
cardiovascular. Nilo industria gráfica S.A. 2003. Pag. 103-104.
Dotevall A., Johansson S, and Wilhelmsen L. Association between fibrinogen and other risk faactors for
cardiovascular disease in men and women. AEP . September 1994; vol 4: 369-374
Peeters A, Barendregt JJ, Willekens F, Mackenbach JP, Al Mamun A, Bonneux L, . Obesity in adulthood and its
consequences for life expectancy: A life-table analysis Ann Intern Med 2003;138:24-32.
ARANCETA J, ET AL. DOCUMENTO DE CONSENSO: OBESIDAD Y RIESGO CARDIOVASCULAR Clin Invest
Arterioscl 2003;15(5):196-233
Gutiérrez-Fisac JL, Banegas Banegas JR, Rodríguez Artalejo F, Regidor. E. Increasing prevalence of overweight
and obesity among Spanish adults, 1987-1997. Int J Obesity 2000;24:1677-82.
Vázquez R., López J. Mª. Obesidad. La epidemia del siglo XXI. Rev Esp Econ Salud 2002; 1, (3): 34-42.
Consenso SEEDO’2000 para la evaluación del sobrepeso y la obesidad y el establecimiento de criterios de
intervención terapéutica MEDICINA CLÍNICA. VOL. 115. NÚM. 15. 2000
Brownell KD, ed. The LEARN program for weight control.7th ed. Dallas: American Health Publishing, 1998.
Brownell KD, Rodin J. The weight maintenance survival guide. Dallas:Brownell&Hager, 1990
Gortmaker SL, Must A, Perrin JM. Social and economic consequences of overweigh in adolescence and young
adulthood. New Engl J Med 1993;329:1008-12.
Barr SI, Yarker KV, Levy-Milne R, Chapman GE.Canadian dietitians' views and practices regarding obesity and
weight management. J Hum Nutr Diet. 2004 Dec;17(6):503-12.
Steptoe A, Kerry S, Rink E, Hilton S. The impact of behavioral counseling on stage of change in fat intake,
physical activity, and cigarette smoking in adults at increased risk of coronary heart disease. Am. J. Public Health.
Feb;91 (2):265-9.
Thomas A., Robert I. , Leslie G. , David B. ,Suzanne P., Robert K. , et al.. Randomized Trial of Lifestyle
Modification and Pharmacotherapy for Obesity. N. engl j med 2005; 353:2111-20.
Shaw K, O'Rourke P, Del Mar C, Kenardy J. Intervenciones psicológicas para el sobrepeso o la obesidad
(Revisión Cochrane). http://www.update-software.com. The Cochrane Library, 2005 Issue 4. ;
Duenas Herrero RM, Aleu Bover M, Gonzalez Tejon I, San Molina L, Salavert Jimenez J, Arranz Marti B. Impact
of medical counseling to quit smoking during the process of dehabituation in patients with mental illness. Actas
Esp Psiquiatr. 2004 Sep-Oct;32(5):287-92.
Wakefield M, Olver I, Whitford H, Rosenfeld E. Motivational interviewing as a smoking cessation intervention for
patients with cancer: randomized controlled trial. Nurs Res. 2004 Nov-Dec;53(6):396-405
McCambridge J, Strang J.The efficacy of single-session motivational interviewing in reducing drug consumption
and perceptions of drug-related risk and harm among young people: results from a multi-site cluster randomized
trial. Addiction.2004.Jan;99(1):39-52.
Burke BL, Arkowitz H, Menchola M.The efficacy of motivational interviewing: a meta-analysis of controlled clinical
trials. J Consult Clin Psychol. 2003 Oct;71(5):843-61
Lugoboni F, Quaglio G, Mezzelani P, Pajusco B, Casari R, Lechi A Improving compliance in internal medicine:
the motivational discussion. Ann Ital Med Int. 2004 Jul-Sep;19(3):155-62. (24). BION, W.R.: Experiencias en
grupos. Ed. Piadós. Barcelona, 1.985.
Burke BL, Arkowitz H, Menchola M.The efficacy of motivational interviewing: a meta-analysis of controlled clinical
trials. J Consult Clin Psychol 2003; 71:843-61.
Lugoboni F, Quaglio G, Mezzelani P, Pajusco B, Casari R, Lechi A Improving compliance in internal medicine:
the motivational discussion. Ann Ital Med Int 2004; 19:155-62.
Bion, W.R.: Experiencias en grupos. Ed. Piadós. Barcelona, 1.985.
Arrebola Vivas, E. et al. Eficacia de un programa para el tratamiento del sobrepeso y la obesidad no mórbida en
atención primaria y su influencia en la modificación de estilos de vida. Nutr Hosp 2013;28:37-141.
Doyle M, Siegel R, Supe K. Stages of change and transitioning for adolescent patients with obesity and
hypertension. Adv Chronic Kidney Dis 2006; 13:386-93.
Prochaska JO, Velicer WF, Rossi JS, Goldstein MG, Marcus BH, Rakowski Wet al. Stages of change and
decisional balance for 12 problems behaviors. Health Psichology 1994; 13: 39-46.
Formiguera i Sala X., Moreno Esteban y el grupo de investigadores del Estudio OBESO. Rev Esp Obesidad
; Supl. Nº 1. Pag: 10-19.
Machin D, Campbell MJ,Fayers P, Pinol A. Sample Size Tables for Clinical Studies. 2nd edition. Oxford.
Blackwell Science, 1997.
Alonso J, Regidor E, Barrio G, Prieto L, Rodríguez C, de la Fuente L. Valores poblacionales de referencia de la
versión española del Cuestionario de Salud SF-36. Med Clin 1998; 111:410-416.
Burke BS.R. The diet history as atool in research. J. Am. Tiet Assoc 1947; 23: 1041-14611.
Omar RZ, Thompson SG. Analysis of a cluster randomized trial with binary outcome data using a multilevel
model. Stat Med 2000; 19 2675-88.
Published
Issue
Section
License
All accepted originals remain the property of JONNPR. In the event of publication, the authors exclusively transfer their rights of reproduction, distribution, translation and public communication (by any sound, audiovisual or electronic medium or format) of their work. To do so, the authors shall sign a letter transferring these rights when sending the paper via the online manuscript management system.
The articles published in the journal are freely used under the terms of the Creative Commons BY NC SA license, therefore.
You are free to:
Share — copy and redistribute the material in any medium or format
Adapt — remix, transform, and build upon the material
The licensor cannot revoke these freedoms as long as you follow the license terms.
Under the following terms:
Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
NonCommercial — You may not use the material for commercial purposes.
ShareAlike — If you remix, transform, or build upon the material, you must distribute your contributions under the same license as the original.
No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License