| Objective: To study the qualitative research based on semi-structured interviews to understand the current status of cognition and demand for resistance exercise rehabilitation in patients with coronary heart disease after PCI,and to analyze the current status and existing problems of resistance exercise rehabilitation in patients with coronary heart disease after PCI,To provide a reference basis for the development of the content framework of the resistance exercise rehabilitation guidance program;based on the evidence-based nursing theory,complete the clinical practice guidelines,Meta analysis and RCT literature research on resistance exercise rehabilitation for patients with coronary heart disease after PCI,and contact China Based on the national conditions,combined with Delphi’s inquiry,construct a sports rehabilitation program for patients with coronary heart disease after PCI and conduct empirical research to provide scientific and standardized guidance for patients with coronary heart disease after PCI and clinical medical staff.It is a reference tool to improve the participation rate and compliance of patients in cardiac rehabilitation,and it also plays an important role in improving the cardiopulmonary function and quality of life of patients and reducing medical expenses.Methods:The first section: Qualitative research on the cognition and demand for sports rehabilitation of patients with coronary heart disease after PCI: Through semi-structured interviews,conduct one-on-one interviews with patients after PCI for coronary heart disease to understand the status quo of patients’ cognition and demand for sports rehabilitation,Combined with the literature response,analyze the current situation and existing problems of patients with coronary heart disease after PCI in sports rehabilitation.The second section: The construction of the "Guiding Plan for Rehabilitation of Resistance Exercise for Patients with Coronary Heart Disease after PCI" : Based on evidence-based nursing theory,clinical practice guidelines,systematic reviews/Meta analysis and RCT literature for resistance exercise related to patients after PCI for coronary heart disease Carry out a comprehensive search and screening,analyze the literature that meets the inclusion criteria;use the clinical guideline research and evaluation system(AGREE II),systematic review/Meta analysis using AMSTAR 2 evaluation tool,RCT literature using the risk of bias assessment tool(Risk Of Bias,ROB)for quality evaluation;based on literature research,contacting China’s national conditions,formulating a draft plan,convening cardiologists,rehabilitation experts,nursing experts,etc.to conduct Delphi expert correspondence,combining expert opinions to construct the The plan was revised and the "Guiding Plan for Rehabilitation of Resistance Exercise for Patients with Coronary Heart Disease after PCI" was finally formedThe third section: Empirical study of "Resistance Exercise Rehabilitation Guidance Plan for Patients with Coronary Heart Disease After PCI" : Select 30 patients with coronary heart disease who were admitted to the Department of Cardiovascular Medicine,the Second Affiliated Hospital of Guangxi Medical University from May to July 2020 As the control group,30 patients undergoing PCI with coronary heart disease admitted from August 2020 to November 2020 were selected as the intervention group,and the observation time was 3 months.The control group was given routine nursing measures and rehabilitation guidance,and the intervention group implemented resistance exercise rehabilitation programs for patients with coronary heart disease after PCI on the basis of the control group.The patient’s exercise acceptance and compliance,exercise safety indicators,cardiac function indicators,quality of life and other aspects of improvement were compared and analyzed to verify the effects of the exercise rehabilitation program.Result: 1.The status quo of awareness and demand for sports rehabilitation of patients with coronary heart disease after PCI: Interviews with 12 patients after PCI with coronary heart disease found that the patients have a certain degree of one-sided and misunderstanding about rehabilitation sports,and lack of sources of relevant information.There are multiple obstacles to participating in sports rehabilitation,such as physical,time,economy,and venue.However,patients urgently need professional guidance from clinical medical staff and continuous sports rehabilitation guidance.2.Relevant literature search and quality evaluation of resistance exercise rehabilitation for patients with coronary heart disease after PCI: The "Guiding Plan for Resistance Exercise Rehabilitation for Patients with Coronary Heart Disease after PCI" includes one "SIGN National Clinical Guideline" issued by SIGN in 2017 : Cardiac Rehabilitation(150)",7 Meta-analysis and 27 RCT articles.The standardized scores included in the guidelines were 97.2%,83.3%,72.9%,86.1%,62.5%,83.3%;the 7 meta-analysis included 2 Chinese and 5English,of which 2 Chinese were "medium quality" and 5 English is "high quality";27 RCT documents include 14 Chinese and 13 English,and the overall quality is good.3.The construction of the "Resistance Exercise Rehabilitation Guidance Program for Patients with Coronary Heart Disease after PCI" : Based on evidence-based nursing theory,combined with the relevant clinical practice guidelines,systematic reviews/Meta analysis and RCT for resistance exercise rehabilitation of patients after coronary artery disease after PCI On the basis of retrieval and screening,literature content analysis and quality evaluation,combined with the Delphi expert correspondence method,the "Resistance Exercise Rehabilitation Guidance Plan for Patients with Coronary Heart Disease After PCI" was constructed.The plan includes the role of exercise rehabilitation and pre-exercise rehabilitation.Evaluation,indications and contraindications for sports rehabilitation,precautions for sports rehabilitation,methods of sports rehabilitation,period and time of sports rehabilitation,frequency of sports rehabilitation,intensity of sports rehabilitation and its detection methods.4.Conduct an empirical study on the scheme: compare the clinical effects of the intervention group and the control group.The results show that: the intervention group’s patients’ unwillingness to participate in rehabilitation exercises is 0,and their willingness to exercise is generally less than that of the control group.< 0.05);The incidence of adverse cardiac events in the intervention group was lower than that in the control group(P<0.05);the average score of CM-PPT and the 6MWT distance of the intervention group after intervention were significantly higher than before the intervention(P<0.05),compared with the control group The average score of CM-PPT and the distance of 6MWT in the intervention group were significantly increased(P<0.05);the total CQQC score of the intervention group was significantly higher than that before the intervention(P<0.05).Compared with the control group,the total CQQC score of the intervention group was significantly increased(P<0.05).The score was significantly higher than that of the control group(P<0.05).Conclusion: 1.Patients with coronary heart disease after PCI have a one-sided cognition of resistance exercise rehabilitation,and there are misunderstandings.There are many obstacles to participating in exercise rehabilitation.There is an urgent need for professional guidance from clinical medical staff and continuous exercise rehabilitation guidance.2.Based on the results of literature research and the status quo and existing problems of patients in resistance exercise rehabilitation,combined with 1clinical practice guide,7 systematic reviews/Meta analysis and 27 RCT literatures,the "PCI of Coronary Heart Disease" was constructed in combination with expert opinions.The "Rehabilitation Guidance Program for Resistance Exercises for Postoperative Patients" has a certain degree of scientificity and applicability.3.The "Resistance Exercise Rehabilitation Guidance Program for Patients with Coronary Heart Disease After PCI" has achieved good clinical results through clinical empirical research.The home exercise rehabilitation program with elastic band resistance exercise as the core can improve patients’ willingness and compliance with rehabilitation exercise activities.It is worthy of clinical application and promotion to reduce the incidence of adverse cardiac events and improve the physical function and quality of life of patients. |
PDF Full Text Request