Changing lifelong habits and adopting new behaviors is a difficult but necessary task for heart patients. As a health care professional, you must play an active role in assisting patients who face this challenge in order to reduce coronary heart disease (CHD) risk. Lifestyle Management for Patients With Coronary Heart Disease provides you with techniques for helping patients change their unhealthy behaviors and improve their quality of life following a CHD event.

Drawing upon more than 20 years of research and clinical experience in the Stanford Cardiac Rehabilitation Program, authors Nancy Houston Miller and Craig Barr Taylor present behavioral interventions and explain how to apply the interventions in a wide variety of health care settings. You will find separate chapters on specific risk factors, including

exercise,

smoking,

diet,

stress, and

medications.

Each of these chapters provides methods for helping patients not only adopt but also maintain lifestyle changes in these areas. You'll find 19 assessment tools and patient resources such as questionnaires and logs to help facilitate lifestyle change. You'll also find information on

elements of a successful behavioral program;

educational methods for behavior change, including printed materials, video, computers, telephone calls, and group interventions; and

psychological issues that may affect a patient's ability to change"depression, anxiety, alcohol and drug abuse, social support and marital status, and stress and anger.

Although the primary focus of this monograph is on patients with established CHD, many of the principles can also be applied to patients at high risk for developing cardiovascular disease. All health care professionals who work with cardiovascular patients, especially those involved in education and counseling, will want to own a copy of this comprehensive and practical guide.

Contents

Assessment Tools and Patient Resources

Preface

Acknowledgments
Chapter 1. Introduction to Lifestyle Management
Chapter 2. Lifestyle Management: Theories of Intervention
Chapter 3. Education, Communication, and Methods of Intervention
Chapter 4. Psychological Issues Affecting Lifestyle Change
Chapter 5. Adherence to Exercise Programs
Chapter 6. Dietary Assessment and Intervention
Chapter 7. Stress Management
Chapter 8. Smoking Cessation
Chapter 9. Adherence to Medications

References

Index

About the Authors

Audiences

Reference for cardiac patients and health care professionals, scholars, and researchers.

Nancy Houston Miller is the associate director of the nationally recognized Stanford Cardiac Rehabilitation Program. Having worked in cardiac rehabilitation for more than 20 years, she has a thorough understanding of what it takes to help patients with coronary heart disease change their lifestyles. Her extensive research in cardiovascular risk reduction has involved work on the development of MULTIFIT, the multiple risk factor intervention program described in this monograph. Since 1973 she has worked with patients in the YMCArdiac Therapy Exercise Program, now known as the Cardiac Therapy Foundation of the Mid-Peninsula, in Palo Alto, CA.

A member of both the American Association of Cardiovascular and Pulmonary Rehabilitation and the American Heart Association, Houston Miller received fellowship awards from these organizations in 1990 and 1991, respectively. She earned her bachelor's degree in nursing from the University of Washington in 1972.

Craig Barr Taylor is the codirector of the Stanford Cardiac Rehabilitation Program. A board-certified psychiatrist, he has more than two decades of experience in clinical and research interventions with coronary heart disease patients. He has been a professor of psychiatry at Stanford University School of Medicine since 1991.

Taylor was a principal investigator on the MULTIFIT research study, a project funded by the National Heart, Lung, and Blood Institute. He, Houston Miller, and others are responsible for developing the American Heart Association's Active Partnership™ Program, which has been used with more than one million patients. A member of the American Association of Cardiopulmonary Rehabilitation and the Society of Behavioral Medicine, Taylor was elected president of the latter organization for the 1995 term. He earned his MD in 1970 from the University of Utah College of Medicine.

"Two internationally recognized experts in cardiac rehabilitation and behavioral medicine provide substantial reinforcement for the challenge of educating and counseling patients, empowering them with the skills to combat recidivism and improve their cardiovascular health and well-being. These authors have uniquely combined their extensive clinical experience to produce an authoritative yet practical text that will maximize success in caring for patients with cardiovascular disease. This monograph is must reading for all health care professionals involved in contemporary cardiac rehabilitation programs."

Barry A. Franklin, PhD

Director, Cardiac Rehabilitation and Exercise Laboratories, William Beaumont Hospital, Royal Oak, MI Professor of Physiology, Wayne State University School of Medicine

"Lifestyle Management for Patients With Coronary Heart Disease converts 20 years of research by the Stanford Cardiac Rehabilitation Program into a blueprint for cardiac lifestyle interventions. The only publication of its kind, this monograph presents all the risk assessment tools with guidelines for their use in a single, concise volume. This new addition to the catalog of cardiac treatment literature is a must for the libraries of health care providers, teachers, and researchers. Any health care professional treating cardiac patients will find this monograph an essential item in his or her arsenal of management remedies and techniques."

Erika Sivarajan Froelicher, RN, PhD, FAAN

Professor, Department of Physiological Nursing, School of Nursing, and Department of Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco