Effects Of Continuity Of Care Based On The Transtheoretical Model Of Behavior On Patients With Permanent Cardiac Pacemaker

Objective:This study was to investigate the depression,anxiety,quality of life,and compliance in patients with permanent cardiac pacemaker,and to evaluate the effect of continuity of care based on the transtheoretical model of behavior on emotion,quality of life and compliance in patients with permanent cardiac pacemaker.MethodsEighty patients with permanent cardiac pacemaker who were selected from three third-grade hospitals of Rizhao between January 2013 and June 2014 were randomized into two groups:control group(group C)and group with continuity of care based on the transtheoretical model of behavior(group S).Patients in group C(n=38)were treated with traditional nursing methods.Patients in group S(n=42)were given continuity of care based on the transtheoretical model of behavior.Before surgery,the patient's basic condition(e.g.age,gender,education,payment of medical expenses,cardiac function classification,and underlying diseases),diseases and relevant knowledge(e.g.knowledge about disease,medication and rehabilitation)were assessed.Changes rising from patients' mood,quality of life and medication compliance in two groups were evaluated at the time before the surgery,1 week,1 month,3 months,6 months and 12 months after surgery respectively.Evaluation instruments include:Self Rating Depression Scale(SDS),Self rating Anxiety Scale(SAS),the short Form-36 health survey table(SF-36),investigation of disease-related knowledge table,and medication compliance questionnaire.Results1.Preoperative basic information of patients(e.g.age,gender,education,payment of medical expenses,cardiac function classification,underlying disease),the cognition of disease and relevant knowledge(disease knowledge,medication knowledge,rehabilitation knowledge)in the two groups were not significantly different(P>0.05).2.Scores for SDS,SAS,SF-36,investigation of disease-related knowledge questionnaire,and medication compliance questionnaire in two groups before surgery were not significantly different(P>0.05).3.Compared with group C,scores for SDS,SAS,SF-36,disease-related knowledge questionnaire,and medication compliance questionnaire in group S at 1 week and 1 month after the surgery were not significantly different(P>0.05);compared with group C,scores for SDS,SAS of patients in group S statistically decreased(P<0.05),scores for SF-3 6,investigation of disease related knowledge questionnaire,and medication compliance questionnaire statistically increased(P<0.05)at 3 months,6 months and 12 months after the surgery respectively.Scores for SDS and SAS in both groups showed a trend of decline with time in patients with permanent cardiac pacemaker,while scores for SF-36 and disease-related knowledge questionnaire showed a trend of rise.Conclusions1.Continuity of care based on the transtheoretical model of behavior could relieve the anxiety and depression in patients with permanent cardiac pacemaker.2.Continuity of care based on the transtheoretical model of behavior could improve the life quality of patients with permanent cardiac pacemaker.3.Continuity of care based on the transtheoretical model of behavior could deepen understanding of the disease and promote the medication compliance in patients with permanent cardiac pacemaker.