Success Comes in Pairs

  by Lisa Spellman  


  For a year during nursing school, Bernice Yates, Ph.D., cared for her mother who was dying of cancer. She held her hand, bathed her and helped her family navigate the medical maze.

Her mother never saw her graduate. But, the personal caregiving experience gave Dr. Yates a richer perspective on the most effective way to help patients make a stronger recovery.

An associate professor in the department of adult health and illness in the UNMC College of Nursing, Dr. Yates will launch a two-year pilot study to look at the outcomes of cardiac rehabilitation on patients and their spouses.

The 40-couple study, funded by a $225,000 grant from the National Institute of Nursing Research, a division of the National Institutes of Health, is being done through the outpatient cardiac rehab centers at The Nebraska Medical Center and Nebraska Methodist Health System.

All patients will participate in exercise and education classes at the cardiac rehab outpatient center, but only half of the patients' spouses will join their partner in the activities. Dr. Yates hypothesizes that cardiac patients have better long-term success if their spouses are included in their rehabilitation program.

"The hope is that what they learn in cardiac rehab will stay with them long after they leave," Dr. Yates said. "And if their spouse is involved in rehab with them, their chances for success go up."

Their support is similar to the compassionate care and support she provided her own family during her mother's illness and after her death. "I was considered the health expert in the family, someone who could provide a caring perspective," she said.

Her study participants will receive similar guidance. For six months, Dr. Yates will follow their progress, noting each milestone in diet and exercise and then tally the results. For the


Bernice Yates, Ph.D., teaches heart patient John Torchia and his wife, Rachel, a new exercise program while Claudia Stolinski, cardiovascular nurse specialist at the Nebraska Medical Center, takes John's blood pressure.

partners of the cardiac patients, Dr. Yates and an interdisciplinary team of nurses, physicians, exercise physiologists and dietitians will assess and counsel them on their risk of heart disease. Goals will be set for all involved and activity levels and lipid profiles will be measured at the beginning, midpoint and end of the study.

Along with their partners, spouses will learn how much exercise they need to do on different types of equipment, such as a treadmill, stationary bike and elliptical to meet their individual goals.

"Everyone should get at least 150 minutes of aerobic activity of moderate or greater intensity per week to maintain optimum health," Dr. Yates said.

Cardiac patients often are uncertain as to how much exercise they can or should do after surgery, she said. "They think they have to take it easy, but the blockages are fixed and their heart is working more efficiently than it has in a long time."

The idea for the study spawned from an earlier research project in which Dr. Yates tracked the behavioral patterns of couples. Out of the 10 observed behaviors, she found that seven were shared behaviors between partners. For example: if one person was inactive, the other person was inactive.


"They either shared positive or negative behaviors," Dr. Yates said.

Her goal is to use the research to secure funding for a larger study. "It's so important to translate the complex instructions we give people into lay terms so they can understand what we want them to do and be successful," she said.

And while surgical techniques to repair heart blockages have been perfected, it won't make a difference, Dr. Yates said, if the patient doesn't adhere to the necessary lifestyle changes.

Dr. Yates' research complements the work being done by her colleagues through a five year, $1.5 million National Institutes of Health grant to create a Healthy Heart Center that promotes health in Nebraskans in rural areas with, or at risk, for heart disease.

"We have a unique opportunity to help people in rural Nebraska lead healthier lives," Dr. Yates said

  discover spring 2010