Application Of The Intervention Based On Interaction Model Of Client Health Behavior In Patients With Coronary Heart Disease After PCI

ObjectiveAccording to the theory of interaction model of client health behavior（IMCHB）,an intervention for clients with coronary atherosclerotic heart disease after percutaneous coronary intervention（PCI）was constructed.In order to provide reference for improving self-management,medication adherence and disease knowledge of patients with coronary atherosclerotic heart disease.Methods1.The intervention for clients with coronary atherosclerotic heart disease after PCI was formed based on IMCHB.By literature research,relevant papers were used to the first draft of the intervention for clients who have coronary atherosclerotic heart disease after PCI based on the IMCHB.The intervention was further developed through experts group meeting and preliminary trial.2.Implementation and effect evaluation of the intervention based on IMCHBIn this study,76 clients with coronary atherosclerotic heart disease after PCI were recruited in the hospital in Kai Feng.The time of operation was the entry order.Clients were evenly divided into control and intervention groups randomly.There were 38 clients in the two groups respectively.The conventional hospital health education was used to control group.The health education included the establishment of electronic medical records,the relevant disease knowledge,the health education of operation,medication,diet and physical exercise,the discharge guidance,the telephone follow-up,etc.The intervention group added the intervention based on the IMCHB.Health education was conducted according to the four parts of the IMCHB.The intervention time was from the end of the operation to 3 months after discharge.The socio-demographic questionnaire,12-item medication adherence scale（12-item MAS）,coronary self-management scale（CSMS）,coronary artery disease education questionnaire short version（CADE-Q SV）and anthropometric measurements（blood pressure,body mass index,blood lipids）were used to investigate.SPSS version 23.0 was used to analyze the data.Frequency and constituent ratio were used to describe the enumeration data.In measurement data,mean±standard deviation was used to describe those conforming to normal distributions,and M(P₂₅,P₇₅)was used to represent those not conforming to normal distributions.This study used Chi-square test to compare enumeration data between two groups,t-test was used to compare those conforming to normal distributions,and rank sum test was used to compare those conforming to skewed distributions.Results1.The intervention for clients with coronary atherosclerotic heart disease after PCI was formed based on IMCHBLiterature retrieval was conducted from the beginning of the databases to November 1,2021.14 literatures were obtained after the selection.Among them,10 literatures were randomized controlled trials and 4 literatures were systematic review.The first draft of the intervention plan was formed according to the literature retrieval results,and the final draft was formed after group discussion and preliminary test.2.Implementation and effect evaluation of the intervention based on IMCHBIn this study,76 cases were admitted,and 7 cases were lost to follow-up.In the control group,there were lost 4 cases,and in the intervention group,it became to be 3.A total of 69 objects completed the experiment,34 cases in the control group and 35 cases in the intervention group.（1）Among 69 clients,the number of male clients was more than 70%in the two groups.Clients in the two groups were 35～73（56.57±7.34）years old,and their educational background was concentrated in middle school.The proportion of clients in two groups with one other disease was the highest（43.5%）.There was no significant difference in age,the number of other diseases,BMI,blood pressure and biochemical indexes between the two groups（P>0.05）,and the baseline of the two groups was consistent.Through the intervention,the results showed no significant difference in blood pressure,biochemical indexes and readmission between the two groups（P>0.05）.BMI in the intervention group（24.61±3.15）was lower than the control group（26.26±3.09）,and the difference was statistically significant（P<0.05）.（2）The total score of the12-item MAS in the control group was（43.29±5.49）,and the total score in the intervention group was（41.20±5.80）before the intervention and there was no significant difference in the scores of 12-item MAS between the two groups（P>0.05）.The score of 12-item MAS in the intervention group was higher after the intervention,and the difference was statistically significant（P<0.05）.The differences in all dimensions were statistically significant（P<0.05）.（3）The score of CSMS was（87.21±9.05）in the control group and（85.23±9.80）in the intervention group before the intervention and there was no significant difference between the two groups（P>0.05）.The score of the intervention group was higher than the control group after the intervention,and the difference was statistically significant（P<0.05）.In the comparison of all dimensions,the differences in the other dimensions were statistically significant（P<0.05）,except the bad habit management（P>0.05）.（4）The score of CADE-Q SV was（8.00±3.08）in the control group and（8.69±3.19）in the intervention group and there was no significant difference in the scores between the two groups（P>0.05）before the intervention.The score of the intervention group was higher than the control group after the intervention,and the difference was statistically significant（P<0.05）.The comparison of scores of each dimension showed statistically significant differences（P<0.05）.ConclusionsIn this study,the intervention based on the IMCHB for the nursing of patients with coronary heart disease after PCI is feasible and effective.The intervention based on the IMCHB can improve the medication adherence,self-management and the understanding of disease knowledge of clients after PCI.Assessing the traits of clients who have coronary atherosclerotic heart disease and promoting the interaction between nursing staff and clients can promote the recovery of clients.