Effect of nurse-led motivational construct intervention programme on lifestyle changes and cardiometabolic risk among obese adults : a single-blind randomised controlled trial

Abstract

This randomised controlled trial aimed to determine the effect of nurse-led motivational construct intervention programme, in comparison to the standard lifestyle modification intervention (LMI), on lifestyle changes and cardiometabolic risk (CMR) profiles among obese adults in Kuantan, Pahang. One hundred obese adults (50 participants in each group) were randomised into either an intervention or control group. Both groups received lifestyle advice on dietary modification, physical activity and behavioural modification skills at baseline. The intervention group also received monthly home visits follow-up for subsequent nurse-led, tailored lifestyle advice. Seventy-nine participants completed the study (39 participants in the control and 40 participants in the intervention group). The outcome measures for lifestyle changes include dietary intake and physical activity level and the CMR includes body mass index (BMI), waist circumference (WC), blood pressure (BP), fasting blood glucose (FBG), low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglyceride (TG) and high-sensitivity C-reactive protein (hs-CRP) levels, assessed at baseline and after six months. Data were analysed using SPSS Version 21. No significant difference in the lifestyle and CMR measures between groups found at baseline. The post-intervention assessments showed that there are no significant changes in the physical activity level and dietary intake except for a reduction in saturated fat intake among the obese adults in the control group after six months (p < 0.05). In addition, the post-intervention assessment reported that the intervention group resulted a significant reduction in BMI, WC, diastolic BP and a significant rise in HDL levels (all p < 0.05). Similarly, the control group exhibited a significant reduction of WC and TG levels after six months (p < 0.05). However, the control group showed a significant rise in the FBG level after six months (p < 0.05), while it stabilised in the intervention group. Additionally, the intervention group also achieved a reduction in the LDL and hs-CRP levels after six months. Nonetheless, there were no statistically significant differences in the lifestyle and CMR measures between the groups after six months (p > 0.05). This study demonstrates that the nurse-led motivational construct intervention programme may be beneficial to treat obesity as well as stabilising the diastolic BP, hs-CRP and the FBG level of adults with obesity. Hence, a larger trial with modifications, sensibly informed by this trial, can now build upon and confirm these results.