| purpose:Investigate the current status and influencing factors of warfarin compliance after heart valve replacement in elderly patients;based on the evidence-based construction of warfarin anticoagulant health education program in elderly patients,to explore the intervention effect of warfarin anticoagulant therapy after heart valve replacement in elderly patients.methods:The investigation stage Elderly patients after 75 heart valve replacement in a third-grade hospital in Jiangxi Province were selected for questionnaire follow-up survey.The factors affecting warfarin compliance after heart valve replacement were analyzed by investigating general data and disease-related data and using the medication adherence scale and warfarin anticoagulant knowledge questionnaire to evaluate their compliance level to warfarin.Integrated data analysis of the collected data using SPSS26.0 software and techniques using descriptive statistics,one-way ANOVA of variance and multiple linear regression to achieve the test level α=0.05.Intervention phase In this stage,two parts of warfarin anticoagulant health education program and application were mainly constructed.Build scheme stage,develop heart valve replacement patients after warfarin anticoagulation health education program,comprehensive the best evidence at home and abroad,combined with the opinions of the team members,determine the health education program draft,and through the barriers and promoting factors analysis,expert group meeting,and other ways,to ensure the scientific nature and effectiveness of this scheme.The stage of intervention program belongs to the experimental study.According to the actual research situation and research conditions,78 patients were hospitalized in the department of cardiac and vascular surgery in a Grade A hospital in Jiangxi Province from June 2022 to November 2022 and met the discharge discharge criteria.Participants were divided into two groups: control group(39)and observation group(39).The control group implemented routine health education in the department,while the observation group,based on the best evidence,implemented warfarin anticoagulation health education program in elderly patients according to the valve replacement.Statistical analysis of the data was performed by using the SPSS26.0software.Counting data meeting the normal distribution are expressed as the mean ±standard deviation,and count data are described as a percentage with a test level of α=0.05.The baseline data of the two groups of intervention.Fruit:Survey stage: In this survey,we distributed a total of 90 questionnaires,and 75 were collected effectively collected,with an effective rate of 83.3%.(1)The overall adherence score of 75 elderly patients undergoing warfarin anticoagulation after heart valve replacement was(5.15 ± 1.14),of which high compliance accounted for 2.7%,medium 17.3% and low 80.0%.(2)Through the analysis of one-way analysis of variance,chi-square test,t-test and other statistical methods,it was found that gender,educational level,occupation and whether to drink alcohol were important influencing factors of patients’ anticoagulation compliance.(3)The results of multiple stepwise analysis showed that whether alcohol consumption and anticoagulation knowledge level were scored as important factors influencing patients’ anticoagulation compliance.Intervention phase:A total of 2 patients were lost to follow-up during the intervention process,and the final number of patients completing the whole study was 39 in the observation group and 39 in the control group.(1)Analysis of warfarin anticoagulant compliance scores after heart valve replacement before and after intervention showed that the observation group and the difference was statistically significant(P=0.031);warfarin compliance was significantly higher 1 month after discharge than the control group(P=0.001);warfarin compliance was higher than the discharge day(P <0.05);warfarin compliance was 1 month after discharge from the day of discharge(P> 0.05).(2)Anticoagulation knowledge scores of elderly patients after heart valve replacement before and after the results showed no difference in warfarin before the intervention(P=0.816),but the warfarin on the day of discharge and 1 month after discharge was significantly higher than that of the control group,and the difference was statistically significant(all P <0.01).(3)There was no significant difference between the incidence of anticoagulation adverse events and the INR compliance rate before and after the intervention(P <0.05).(4)Chi-square test was used to compare the two groups,and the difference between the two groups was significant at 1 month after discharge(P <0.05).conclusion:The main influencing factors of warfarin medication adherence after heart valve replacement in elderly patients were alcohol consumption and warfarin anticoagulation knowledge scores.Based on evidence-based elderly patients after valve replacement warfarin anticoagulation health education program can improve patients warfarin medication compliance,can improve the level of anticoagulation knowledge,improve patients regular monitoring rate,improve the health of patients,ensure the safety of patients,for clinical staff to provide scientific and effective anticoagulation education and management. |
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