| 【Objective】1.To understand the current status of discharge readiness of post-PCI patients with coronary artery disease and to explore the influencing factors through questionnaire method.2.To further explore the real thoughts affecting the readiness for discharge from the perspective of postoperative coronary heart disease PCI patients with insufficient readiness for discharge through semi-structured interviews to supplement the relevant information that could not be obtained from quantitative studies.3.Based on the information-knowledge-attitude-practice theory,an intervention program for discharge readiness of post-PCI patients with coronary artery disease was constructed to provide a theoretical basis and reference for discharge readiness of post-PCI patients.【Methods】This study is divided into three parts.Part I: Quantitative study of discharge readiness of patients after coronary artery disease PCIFrom February 2021 to July 2021,201 patients with coronary artery disease post-PCI in the cardiology departments of one of the three tertiary hospitals in Jinan,Shandong Province were selected using a convenience sampling method,and surveyed and analyzed using the General Information Questionnaire,Discharge Readiness Scale,Discharge Guidance Quality Scale,Social Support Scale and Coping Efficacy Scale,and statistical analysis was performed using SPSS software.Part II: Qualitative study of discharge readiness of patients after PCI for coronary artery diseaseUsing the purposive sampling method,14 patients with inadequate discharge readiness in the first part of the quantitative study were selected as interviewees for in-depth interviews to analyze and summarize the unmet needs and problems of patients at discharge readiness.Part III: Construction of a discharge readiness intervention program for post-PCI patients with coronary artery diseaseThrough the preliminary investigation of the current situation of discharge readiness of patients after coronary artery disease PCI and the analysis of the influencing factors,as well as the refinement,analysis,summarization and conclusion of the qualitative interview content,an intervention plan based on IKAP theory was initially formed for the discharge readiness of patients after coronary artery disease PCI.【Results】Part 1:(1)The readiness for discharge scores of 201 patients after coronary PCI ranged from 77 to 96,with an overall mean score of(89.13±3.43)and a mean entry score of(7.42±0.28).Among the three dimensions,the personal status dimension had the highest score,which was(7.44±0.34),followed by the anticipatory support dimension with a score of(7.42±0.33),and finally The quality of discharge instructions for patients with coronary heart disease after PCI was(129.86±4.93),social support was(33.38±3.54),and coping efficacy was(49.52±7.88);Pearson’s correlation analysis showed that the readiness for discharge score was associated with the total quality of discharge instructions score,total social support score,and coping efficacy score,which was(7.41±0.31).Pearson correlation analysis showed that the correlation coefficients of readiness for discharge and the total score of discharge instruction quality,social support,and coping efficacy were 0.619,0.583,and 0.610,respectively,that is,readiness for discharge was positively correlated with discharge instruction quality,social support,and coping efficacy,respectively(P<0.01).(2)Discharge readiness scores of patients after coronary PCI differed across general demographic sociological data and disease data,and univariate analysis showed that gender(P=0.003),age(P=0.001),marital status(P=0.016),education(P=0.005),residential address(P=0.018),monthly per capita household income(P= 0.027),family history of coronary artery disease(P=0.021),and comorbid diseases(P<0.001)were statistically significant differences in the degree of discharge readiness of patients after PCI for coronary artery disease.(3)Multiple linear regression analysis showed that gender(P<0.001),marriage(P=0.006),residential address(P<0.001),total discharge instruction quality score(P<0.001),total social support score(P=0.007),and total coping efficacy score(P<0.001)were the main factors affecting the degree of discharge readiness of patients after PCI for coronary artery disease.Part II:A total of 14 postoperative patients with coronary artery disease PCI were selected for semi-structured interviews,and the distilled themes were:psychological ambivalence in the face of discharge(desire for discharge,internal anxiety and irritability),lack of disease-related information(few sources of information,need for disease-related knowledge),prominent psychological problems(negative emotions,heavy burden of self-perception),and desire to seek multiple support(support from healthcare professionals,family support,peer support).Part III:After two rounds of expert correspondence,the final version of the intervention program for discharge readiness of patients after PCI for coronary heart disease was constructed.This program consisted of two parts:the specific implementation plan and the content of the intervention indicators,in which the specific implementation plan consisted of four intervention steps,I(collecting information),K(providing knowledge),A(enhancing coping beliefs),and P(taking action),and the content of the intervention indicators consisted of 70 items.The questionnaire recall rates of the two rounds of expert correspondence were 100% and 93.75%,the authority coefficients of the experts were 0.903 and 0.906,and the Kendall’s harmony coefficients of the first,second,and third level indicators after the two rounds of expert correspondence were 0.222,0.286,and 0.315,respectively(P<0.05),which were statistically significant for the high degree of coordination of the experts,and the correspondence results had some reliability.【Conclusion】1.The discharge readiness of patients after PCI for coronary artery disease was moderately low,and there were differences in the readiness of patients by gender,age,marital status,education level,residential address,per capita monthly household income,comorbid diseases,and whether they had a family history;the quality of discharge instructions,social support,and coping efficacy of patients were positively correlated with their discharge readiness and were influencing factors of their discharge readiness.2.Based on IKAP theory,combined with cross-sectional survey and qualitative interview,this study established an intervention program for discharge readiness of patients after PCI for coronary artery disease.The results of the study are scientific and reliable after two rounds of expert correspondence,and can be used for clinical healthcare professionals to carry out interventions for patients after PCI for coronary artery disease,in order to help patients improve their discharge readiness and enable them to be discharged safely.correspondence,and can be used by clinical healthcare professionals to carry out interventions for post-PCI patients with coronary artery disease to help patients improve their discharge readiness and enable safe discharge. |
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