| Objective:Based on the investigation of cardiac rehabilitation information needs of discharged patients after coronary stenting,this study constructed a structured home cardiac rehabilitation education program based on the theory of knowledge,belief and practice,and conducted intervention research with the help of We Chat platform,aiming to provide better nursing services for patients after coronary stenting,so as to improve the quality of life and improve the prognosis,and provide reference for the future clinical promotion and application of this program.Methods:1.Questionnaire method: In the form of questionnaire stars,275 discharged patients after coronary stenting in three provincial third class general hospitals were investigated with the cardiac rehabilitation information demand scale with good reliability and validity to understand the patients’ needs for home cardiac rehabilitation.2.Literature analysis: under the guidance of the theory of knowledge,belief and practice,combined with the results of the previous questionnaire survey,access to domestic and foreign literature related to coronary stenting,home cardiac rehabilitation,structured education,etc.,combined with China’s cardiac rehabilitation guidelines and expert consensus,extract the indicators of knowledge,belief and action related to home cardiac rehabilitation education,The index system of structured home cardiac rehabilitation education program for patients after coronary stenting was preliminarily formulated.3.Research group discussion method: after discussion and research by the research group,the index system of the initially proposed structured home cardiac rehabilitation education program for patients after coronary stenting was further supplemented and improved to form the first round of expert consultation table.4.Delphi method: experts in relevant fields inside and outside the province(16 in the first round and the second round)are selected as the correspondence experts for this study.After two rounds of expert consultation,the structured education program for home cardiac rehabilitation of patients after coronary stenting was finally determined.5.Randomized control method: 80 patients in the cardiovascular department of a third class general hospital after coronary stenting were selected and randomly divided into intervention group and control group,with 40 patients in each group;The control group received routine health education intervention during hospitalization and after discharge;During hospitalization and after discharge,the intervention group implemented the home cardiac rehabilitation program constructed in this study on the basis of routine health education.The quality of life and readmission rate of the two groups were compared before and 3 months after the intervention.6.Statistical methods: SPSS25.0 software was used for data analysis,including chi square test,paired sample t-test,independent sample t-test.The positive coefficient,authority coefficient and Kendall harmony coefficient of experts are used to judge the reliability of the study.Results:1.Questionnaire investigation:The total score of patients’ demand for cardiac rehabilitation information after coronary stenting was(204.94±28.59),and the score of each dimension from high to low was(37.64±6.49),risk factors(33.70±6.49),heart(26.65±3.94),medicine(22.13 ±2.95),pressure or psychological factors(21.25±3.71),emergency or safety(18.22±2.11),nutrition(17.41±2.72),work or occupation or society(11.18±3.38),Diagnosis and treatment(9.07±1.18),general or social concern(7.69±2.08).2.Literature analysis: A total of 27 directly related literatures were finally included.On the basis of needs assessment,literature review and research group discussion,based on the theory of knowledge,attitude and practice,the index system of home cardiac rehabilitation structured education program for patients after coronary stent implantation was initially constructed,including 3 first-level indicators of health knowledge,health belief and health behavior,and 31 second-level indicators.3.Delphi expert consultation: the number of experts invited to participate in the two rounds of correspondence is 16,the enthusiasm of experts in the two rounds of consultation is 100%,and the authority coefficient is 0.83;After two rounds of expert consultation,the Kendall harmony coefficient of the importance of each indicator is0.236～0.313,and the coordination degree of expert opinions tends to be consistent χ2The difference was statistically significant after the test(P<0.05);After two rounds of correspondence,the coefficient of variation of the importance of each index is0.05～0.20,and the experts’ opinions are concentrated.After two rounds of correspondence,3 secondary indicators were deleted,1 secondary indicator was added,and 3 secondary indicators were modified.Finally,the indicator system of structured home cardiac rehabilitation education program for patients after coronary stenting was confirmed,including 3 primary indicators and 29 secondary indicators.4.Three months after the structured education program of home cardiac rehabilitation based on the theory of knowledge,belief and practice intervened patients after coronary stenting,the quality of life in the intervention group was significantly higher than that in the control group,and the readmission rate was lower than that in the control group,with a statistically significant difference(P<0.05).Conclusion:1.The questionnaire survey shows that the overall demand for cardiac rehabilitation information of patients after coronary stenting is at a medium to high level.2.Based on the theory of knowledge,belief and practice,this study has constructed an indicator system of structured education program for home cardiac rehabilitation of patients after coronary stenting,including 3 first level indicators and29 second level indicators.The results are scientific and can provide theoretical basis for home cardiac rehabilitation after coronary stenting to meet the individual health needs of patients.3.The structured home cardiac rehabilitation education program based on the theory of knowledge,belief and practice can effectively improve the physical condition and quality of life of patients after coronary stenting,reduce the readmission rate of patients,and provide certain clinical practice reference for hospitals and communities. |
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