The Effect Of Motivational Interventions Based On The Integrated Theory Of Health Behaviour Change On Cardiac Rehabilitation

Objective1. To determine if motivational interventions based on The Integrated Theory of Health Behavior Change (ITHBC) is more effective than tranditional intervention in improving adherence of cardiac rehabilitation, effectiveness of cardiac rehabilitation, quality of life and self-efficacy.2. To explore13patients’ experiences of participating in an motivational intervention group.Method1.139patients with coronary heart disease were randomized to the motivational group or traditional group. All patients received routinely care and in-hospital cardiac rehabilitation, in addition,6months follow-up. Besides, Patients in motivational group received motivational interviewing base on ITHBC in which educator help patients to identify risk factors, consider options, set rehabilitation goals.rehabilitation diary, physical variables, self-efficacy, the quality of life scores were followed up and analyzed.2. In-depth interviews were used to explore13patients’s experiences of participating in an motivational group. All interviews were audio-taped and the transcripts were analysed by editing and immersion.Result1.67patients in motivational group and68patients in traditional group completed the six months follow-up. Using motivational interventions can improve exercise adherence (F=7.420,P=0.007), general health and physical function scores of SF-36, and decrease level of SBP at3months(F=6.344,P=0.013) obviously compared with that in traditional group. No significant differences (F=0.01, P=0.94) were found in GSES、BMI、DBP、HR and smoking between the two groups.2.(1)13patients were interviewed. Three main categories crystallized form the interviews:the main obstacle of attendance at cardiac rehabilitation were improper knowledges of CHD and lack of confidence to change unhealthy lifestyle.(2)motivational interviewing give patients an opportunity to "tell their story", actively participate in making rehabilitation scheme improving their disease perceptions.(3) The Key to keep adherence of CR is to provide early education and strengthen follow-up.Conclusion1. Motivational intervention based on ITHBC increased the attendance of cardiac rehabilitation and reported physical activity, a method of which improved adherence of behaviour change with patient-centered, is important to CHD patients. Its improves patients’ ability of self-management, and increases their disease related knowledge, and then improves their compliance of rehabilitation, their ability of physical activity, at last, reduce disease risk factors2. The adherence of self-care in CHD patients is decreased with the extension of time post discharge, what we should do is constantly strengthen follow-up to increase their physical activity, and decrease their unhealthy habits.3. Motivational interviewing is a way to improve nurse-patient relationship.