Effect Of Continuous Nursing Based On Teach-back Method On Self-management Behavior And Quality Of Life Of Young And Middle-aged Patients After Aortic Dissection Surgery

Objective:Through qualitative analysis,the disease cognition and self-management performance of young and middle-aged patients after aortic dissection surgery were obtained.Based on this,a feedback continuous nursing intervention scheme was constructed and applied to young and middle-aged patients after aortic dissection surgery,and the influence of this scheme on their postoperative health knowledge,self-management and quality of life was discussed,so as to provide reference for the application of feedback method in continuous nursing of patients after aortic dissection.Methods:1.The first part of this study is a qualitative study: All aortic dissection surgical postoperative patients were selected from a grade A tertiary hospital in Jiangxi Province,and they discharged or returned to the hospital in January 2022 through February 2022.Their disease cognition,self-management behavior,promoting factors,difficulties and real needs after discharge were deeply analyzed through telephone interviews,and the data were processed by the phenomenological Colaizzi 7-step method.2.The second part is experimental study: based on the results of previous qualitative research,the consensus,guidelines and related literature of aortic dissection experts,a health education manual suitable for young and middle-aged patients after aortic dissection surgery is formulated,and a continuous nursing intervention scheme based on feedback method is constructed accordingly.From April 2022 to October 2022,young and middle-aged patients discharged from the Department of Cardiovascular Surgery were selected.According to the discharge time,the patients were numbered,and the random numbers were generated by SPSS 26.0software,and they were randomly divided into two groups at a ratio of 1:1.The control group was given We Chat continuous nursing,and the experimental group was given teach-back continuous nursing intervention on this basis,with a total of 6 weeks and twice a week.Including the formation and etiology of aortic dissection,the manifestations and treatment of aortic dissection,postoperative symptoms,diet,blood pressure,pulse and weight,exercise,mood,daily life and medication management,prognosis analysis and follow-up,the single intervention time was controlled at 30 ～60 min.SPSS 26.0 was used to analyze the general data of patients,health knowledge,self-management and quality of life data before intervention,1 month and 3 months after intervention.Results:1.Part 1:Through the analysis of interview data of 15 young and middle-aged patients with aortic dissection,this paper analyzes their disease cognition and self-management performance,and extracts four themes: insufficient disease perception,multi-dimensional self-management,diversified self-management needs,and life imbalance caused by disease burden.2.Part 2:(1)A total of 60 subjects were included,with 30 cases in the control group and30 cases in the experimental group.There was no significant difference between the two groups in terms of general information,health knowledge,self-management and quality of life scores before intervention(P > 0.05).(2)Compared with the control group,the scores of health knowledge in the experimental group were significantly higher at each time point(P < 0.05).The analysis of variance of repeated measurement showed that there were significant time,group and their interaction effects in patients’ health knowledge scores(P < 0.05).Paired comparison within the group found that the health knowledge of the patients in the two groups at each period after intervention was significantly higher than that before intervention(P < 0.05),and the score at 3 months after intervention was significantly higher than that at 1 month after intervention(P < 0.05).Trend chart showed that the change trend of health knowledge scores of patients in the two groups is to increase with time.(3)Compared with the control group,the self-management scores of the experimental group were significantly higher at each time point(P < 0.05).The analysis of variance of repeated measurement showed that there were significant time,group and their interaction effects in patients’ self-management scores(P < 0.05).Paired comparison within the group found that the self-management scores of the two groups were significantly higher at each time period after the intervention(P < 0.05),and the scores at three months after the intervention were significantly higher than those at one month after the intervention(P < 0.05).Trend chart showed that the change trend of self-management scores of patients in the two groups is to increase with time.(4)The quality of life in the experimental group was significantly higher than that in the control group at all time points(P < 0.05).Analysis of variance of repeated measurements showed that there were significant time,group and interaction effects between them(P < 0.05).Paired comparison within the group found that the quality of life level of patients in both groups was significantly higher at each time period after intervention(P < 0.05),and the score at 3 months after intervention was significantly higher than that at 1 month after intervention(P < 0.05).Trend chart showed that the change trend of quality of life in the two groups is to improve with time.Conclusion:Wechat-based continuing nursing intervention has a certain effect on the rehabilitation of young and middle-aged patients with aortic dissection surgery.Based on this,this study combined with teach-back method to intervene patients,which greatly improved their health knowledge level,self-management behavior and quality of life,proved the effectiveness and popularization value of continuing nursing intervention based on teach-back method in young and middle-aged patients,and provided reference experience for the application of feedback method in continuing nursing of patients with aortic dissection.