| Purpose:To understand the current situation of disease knowledge, disease attitude and self-management behavior among coronary heart disease patients in community;Discuss the effect of IMB nursing intervention to improve self-management behavior of coronary heart disease patients in community; To provide the basis for making effective self-management mode among coronary heart disease patients in community;To provide the new idea and reference for further related research.Methods:By convenience sampling, chose respectively 40 coronary heart disease patients who established health files from two communities in Changchun. To avoid contamination effect, the two communities were randomly divided into experimental group and control group. The experimental group patients received nursing intervention measures worked out on the basis of IMB skills model as the theoretical framework on the premise of traditional health education. The nursing intervention measures worked out on the basis of IMB skills model were divided into preparation stage, information transmission stage, motivation building stage and skill teaching stage.(1) Preparation stage: evaluate the disease knowledge level of patients and attitude towards disease, fully understand the psychological status and the actual demand of patients.(2) Information transmission stage: according to the survey of disease knowledge demand of coronary heart disease patients in preparation stage, the demand for knowledge of coronary heart disease patients in experimental group included: the causes of coronary heart disease, the onset clinical manifestations when coronary heart disease attacks, the inducing factors of coronary heart disease, the drug effect, the emergency First Aid Treatment, the instruction of diet and exercise rehabilitation. The health education lecture was held respectively once in the early andV middle of each month, for 30 minutes at a time, a total of 6 times.(3) Motivation building stage: after each time information transmission stage, then entered motivation building stage. Motivation building stage regarded enhancing patients participation in health behavior intention as the goal, and built patients self-management behavior motivation system from two aspects of personal motivation and social motivation. The intervention form included: case demonstration, goal setting and exchange of coronary heart disease patients.(4)Skill teaching stage: after each time motivation building stage,then entered skill teaching stage. Behavioral skills including self-test heart rate method, measuring blood pressure method, smoking cessation method(mouth wash with lemonade, exercise, SMS to quit smoking, keep early hours, eating more fruits and vegetables),shadowboxing(video information),salt restriction(give out limited salt spoon). The control group patients received traditional health education, and the health education lecture was held respectively once in the early and middle of each month, for 30 minutes at a time, a total of 6 times. Six lectures were held respectively around a theme, including the concept and type of coronary heart disease, the risk factors of coronary heart disease, the inducing factors of coronary heart disease and the onset clinical manifestations when coronary heart disease attacks, the standard medication and cure measure of coronary heart disease, the self help of coronary heart disease, and the secondary prevention of coronary heart disease. Before the intervention, after one-month intervention and after three-month intervention,respectively issued two groups of patients with coronary heart disease CHD disease knowledge questionnaire, CHD disease attitude questionnaire and CHD self-management behavior scale. The data was double entry by Epidata3.1, and the database was established after the data was imported Excel2003.Used the SPSS13.0statistical software to analyze data.Results:1.Before the intervention, two groups of patients with general information, the score of disease knowledge, positive attitude, negative attitude, the total score of self management and the score of each dimension, differences had no statistical significance(P>0.05),indicating baseline levels of two groups of patients.2.After one-month intervention, the disease knowledge score of experimental group patients was higher than that of the control group patients, having a significance difference(P<0.05).After three-month intervention, the disease knowledge score of experimental group patients was higher than that of the control group patients, having a significance difference(P<0.01).Before the intervention, after one-month intervention, after three-month intervention, the disease knowledge scores of experimental group patients during three stages made a comparison, having a significance difference(P<0.01).Before the intervention, after one-month intervention,after three-month intervention, the disease knowledge scores of control group patients during three stages made a comparison, having a significance difference(P<0.01).3.After one-month intervention, the positive attitude score of experimental group patients was higher than that of control group patients, having a significance difference(P<0.05).After three-month intervention, the positive attitude score of experimental group patients was higher than that of control group patients, having a significance difference(P<0.01).Before the intervention, after one-month intervention,after three-month intervention, the positive attitude scores of experimental group patients during three stages made a comparison, having a significance difference(P<0.01).Before the intervention, after one-month intervention, after three-month intervention, the positive attitude scores of control group patients during three stages made a comparison, having a significance difference(P<0.01).4.After one-month intervention, the negative attitude score of experimental group patients was lower than that of control group patients, having a significance difference(P<0.05).After three-month intervention, the negative attitude score of experimental group patients was lower than that of control group patients, having a significance difference(P<0.01).Before the intervention, after one-month intervention,after three-month intervention, the negative attitude scores of experimental group patients during three stages made a comparison, having a significance difference(P<0.01).Before the intervention, after one-month intervention, after three-month intervention, the negative attitude scores of control group patients during three stages made a comparison, having a significance difference(P<0.05).5.After one-month intervention, the self management total score of experimental group patients was higher than that of control group patients and the each dimension score of experimental group patients was higher than that of control group patients,having a significance difference(P<0.05).After three-month intervention, the self management total score of experimental group patients was higher than that of control group patients and the each dimension score of experimental group patients was higher than that of control group patients, having a significance difference(P<0.05).Before the intervention, after one-month intervention, after three-month intervention, the self management total score and the each dimension score of experimental group patients during three stages made a comparison, having a significance difference(P<0.01).Before the intervention, after one-month intervention,after three-month intervention, the self management total score of control group patients during three stages made a comparison, having a significance difference(P<0.01).Before the intervention, after one-month intervention, after three-month intervention, the remaining dimension score except general life management dimension of control group patients during three stages made a comparison, having a significance difference(P<0.05).Conclusion:1.IMB nursing intervention can improve the disease knowledge level of coronary heart disease patients in community.2.IMB nursing intervention can enhance the level of positive attitude of coronary heart disease patients in community and reduce the level of negative attitude.3.IMB nursing intervention can improve the level of self-management of coronary heart disease patients in community.4.The nursing intervention measures worked out on the basis of IMB skills model as the theoretical framework is superior to traditional health education for coronary heart disease patients in community and can provide reference and basis for working out nursing intervention measures for community health workers. |
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