Intervention Study Of Information-motivation-behavioral Skills Model On Heart Failure Patients Self-management

ObjectiveTo find out the self-management status of patients with heart failure(HF);to discuss the intervention effects of information-motivation-behavioral skills model(IMB)on patients with heart failure in self-management;to provide nursing intervention strategy for heart failure patients in the hospital and at home.MethodsWe collected 200 patients with heart failure from Department of Cardiology of first-class hospital of Shandong province from January 1,2016 to December 31,2016 according to inclusion and exclusion Criteria.IMB was employed to formulate and implement self-management intervention strategy.We investigated self management ability and the intervention effect using questionnaire of characteristics of patients,quality of life of Minnesota heart-failure patients,self management,self-care index scale.And we collected and analyzed the change of knowledge and self management ability of patients at the date of admission,discharge and discharge for 2 week.We analyzed Data using SPSS 23.0 statistical software,and statistical indicators included mean,standard deviation,rate,the proportion,et al.Results1.200 cases of heart failure patients were included,5 cases died,7 patients were lost to follow-up.The effective sample size was 188 cases samples,and effective rate was 94.00%.2.The demographic characteristics of objects,of our study:heart failure patients of 60 years old or above accounted for 81.91%;Men(62.23%)higher than women(37.77%),and gender ratio was 1.65:1;143 of patients were with degree of junior high school which accounted for 76.06%;Spouse and/or children to take care of the patients(60.64%);incident rates of heart failure rates were similar between city(55.32%)and rural(44.68%);Patients with health insurance to pay costs accounted for 96.28%.3.Study disease characteristics:188 patients with heart failure were New York cardiac function class Ⅲ～Ⅳ,which accounted for 89.89%;Coronary heart disease(CHD)occupied the top of the heart failure causes(54.79%),followed by cardiomyopathy(25.00%),and hypertension,valvular disease were 14.98%and 13.83%respectively;The complication of hypertension was 34.04%,followed by diabetes(28.72%).4.Life quality of heart failure patients is poor(score 69.02 ± 16.31);Each dimension score:physical field 27.63 ±7.45,mood field 15.94±5.06,and 25.45±6.21 in other fields.5.In our study,heart failure patient self-management ability level is low(42.42±9.37).Using IMB model to develop self-management interventions at the date of admission,discharge and discharge for 2 week.Patients’ knowledge of self management,self care nursing management,nursing,confidence and self care ability were significantly different P<0.001(F= 620.75,P= 0.000;F=216.66,P = 0.000;F = 412.76,P = 0.000;F＝171.35,P=0.000;F=492.44,P=0.000).ConclusionsLife quality of heart failure patients is poor,and the ability of self management level is low.Personalized self-management interventions according to the IMB model would provide the patients with self management knowledge,motivation and skills,and improve the ability of self management of patients with heart failure.