The primary objective of the proposed clinical trial is to investigate the effectiveness of nurse-mediated interventions to improve functional status and adherence to the Step-One Diet to lower blood cholesterol in women following coronary artery bypass surgery. The nursing intervention is based on Self-Efficacy Theory which posits that people who judge themselves as being capable of performing a behavior are more likely to act, expend more effort, and persist in the face of obstacles or aversive experiences. The study is designed as a randomized clinical trial of efficacy enhancing interventions mediated by nurses compared to """"""""usual care"""""""" administered by primary care providers in the traditional medical system. Three hundred ten female patients who have met the eligibility criteria will be randomly assigned to the nursing intervention group or the usual care group and followed for outcome evaluation at 6 and 12 months. The major outcomes will be levels of functional status and adherence to the Step-One Diet. Statistical analysis will focus on the comparison of mean levels of functional status between groups and the proportion in each group who adhere to the Step-One Diet. In addition, multiple regression analysis will be performed to determine the predictors of improved functional status, adherence to the Step-One Diet, and changes in risk factors in the overall group. This study is significant because of the lack of prior intervention studies and longitudinal investigations specifically targeted for women who generally experience poorer outcomes following coronary artery bypass surgery.
