| Purpose:To study the status quo of self-management of coronary heart disease incommunity; To explore the difference of self-management of coronary heart diseasethrough health education and motivational interviewing and transtheoretical modelintervention; To offer intervention for improving self-management of coronary heartdisease in community.Methods:First, we chose two communities in Changchun by convenient sampling, then105patients were randomly selected from the health records who must meet the inclusioncriteria and exclusion criteria. To avoid contamination effect, one of the communitieswas defined as experimental group with52patients, the other was control group with53patients.16investigators were given a unified training, then they started toinvestigate the two groups. The experimental group were given routine healtheducation and motivational interviewing and transtheoretical model intervention for6months, and the control group were given routine health education only. Healtheducation was held once a month and every seminar took30～40minutes, whichincluded the definition of coronary heart disease, risk factors and the signs andsymptoms of the disease;effects of bad living habits, negative emotions,complications, and treatment adherence to disease; cause and clinical manifestation ofangina and myocardial infarction and how to rescue. Motivational interviewing andtranstheoretical model intervention were played in the form of one-on-one interviews.Patients in the experimental group were given tailored programs according todifferent stages of behavior change. Patients who were in the precontemplation and contemplation stage were given intervention1～2times per month, which aimed tostimulate patients’ intrinsic motivation for good behaviors; patients who were in thepreparation and action stage were given intervention once a month, which aimed toassist the patients to develop tailored programs, and guide the patients to solve theproblems they met in the process of behavior change; in the last stage—maintainstage, patients were given telephone follow-up, which aimed to improve the patients ’level of self-efficacy. Interview content included quitting alcohol, diet, exercise,medication and other risk factors. Use general situation questionnaire and coronaryartery disease self-management scale to investigate self-management score and eachdimension score in patients with coronary heart disease from community beforeintervention,3months and6months after intervention, and compare the scoresbetween the two groups. Set up a database by EpiDate3.02,and use SPSS17.0software to analyze data. The general situation of all the coronary heart diseasepatients were analyzed by frequency, percentage, t-test, chi-square test;self-management total score and each dimension score were analyzed by mean andstandard deviation; scores between the two group by two independent samples t-test,scores before and after intervention in one group by repeated measure ANOVE.Inspection level alpha set to0.05.Results:(1) The level of self-management of coronary heart disease patients in communityis at a below average (68.89±4.56), and in the three aspects, daily life managementwas the highest (57.6%), followed by emotional cognitive management (52.3%),medical management (47.2%) was the last.(2) The baseline of self-management score and every dimension score had nostatistical significanc（eP>0.05）in two groups. After three and six months intervention,the difference between the two groups was statistical significance（P<0.05）in theself-management score and each dimension score.(3) Compare three and six months after intervention with the baseline, theexperimental group in the aspect of self-management score and each dimension had improved significantly, the difference was statistically significant（P<0.05）;comparesix months with three months after intervention, except emotion recognition andtreatment compliance management; the rest of the dimensions and theself-management total score were statistically significant（P<0.05）.(4) Compare three and six months after intervention with the baseline, excepttreatment of compliance management, the rest of the different dimensions and totalscores of self-management in the control group had statistical significance（P<0.05）;compare six months with three months after intervention, except general management,emotion recognition and treatment compliance management, the rest of the differentdimensions and self-management scores had statistical significance（P<0.05）.Conclusion:(1) The level of self-management of coronary heart disease patients fromcommunity is at below average.(2) Health education can improve self-management level of coronary heartdisease patients in community, it has a positive impact on improving the prognosis ofpatients.(3) Motivational interviewing and transtheoretical model intervention canimprove bad behavior habits, then improve self-management level of coronary heartdisease patients in community, so it can be applied in coronary heart disease (CHD)patients in community to improve the self-management level. |
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