| ObjectivesUnderstand the status quo and influencing factors of the knowledge of patients with coronary heart disease, self-efficacy and depression; The evaluating with the effects of Steering cardiac rehabilitation programme on the patient’s level of knowledge, self-efficacy and depression; The further evaluating with the effects of telephone follow-up intervention on the patient’s self-efficacy and depression。MethodsThis study was the similar experimental research。 Select three of the synthetical hospitals in Changzhi City,90CHD patients was experimental subjects into the group which was randomly assigned to the experimental group and a control group of45patients。The control group received conventional health education, including:a predisposing factor for coronary heart disease; diet principles; medication guide conventional family health。Before the intervention (T)、 after the intervention (To)、 the patients were measured with the disease knowledge、self-efficacy、 depression, using coronary heart disease knowledge questionnaire、the Self-Efficacy Scale、the Hamilton Depression Scale。The experimental group received routine health education, but also to accept the self-management education。Assessment and intervention of patients with lifestyle risk factors control and cardiac rehabilitation measures, Including collective teaching, session60minutes, personal guidance2times, each time15-30minutes。Go to training by the personalized exercise prescription writing by the doctor in charge with the patient’s living habits and living environment and giving regular telephone visit, before the intervention (T)、after the intervention (To)、after the intervention of one month (T1)、after the intervention of three months (T3), the patients were measured with the disease knowledge、 self-efficacy、depression, using coronary heart disease knowledge questionnaire、the Self-Efficacy Scale、the Hamilton Depression Scale。 Results1. Coronary heart disease knowledge score was9.52±3.25。Multiple linear regression analysis of educational level、living conditions、medical expenses sources、cardiac function classification、gender、age and numbers of comorbidities into the regression equation, the coefficient of determination (R2) was0.363, the multiple correlation coefficient (R) was0.603。Independent samples t-test showed intervention prior to the experimental group and the control group knowledge score was not statistically significant (P>0.05)。2. Self-efficacy average score in patients with coronary heart disease was6.47±0.95。Symptom management self-efficacy (1-4Items) average score was6.58±1.29。The disease common management self-efficacy average score was6.47±1.14。Multiple linear regression analysis of education level、occupation、marital status、living conditions into the equation、the coefficient of determination (R2) was0.191, and the multiple correlation coefficient R was0.428。Independent samples t-test showed two sets of self-efficacy total score and the average、symptom management self-efficacy average、the disease common management self-efficacy average were not statistically significant (P>0.05)。3. Level of depression in patients with coronary heart disease score was39.54±9.25。Multiple linear regression analysis educational level、 cardiac function classification marital status、living conditions into the equation, the coefficient of determination (R2) was0.277, the multiple correlation coefficient R was0.526。Independent samples t-test showed the level of two groups of patients with depression was not statistically significant (P>0.05)。4. Repeated measures analysis of variance showed that main intervention effect on knowledge scores was significant(P<0.05), in other word, knowledge scores was significantly different between different interventions without taking account the change of time; the main time effect on knowledge scores was significant(P<0.05); there was significant interaction between time and intervention, and interaction diagram indicated that the increase degree of knowledge scores was higher in intervention group than that of control group over time after intervention。Coronary heart disease before and after the paired t-test the experimental group and the control group intervention knowledge scores were statistically significant (P<0.05), and the control group score improve by less than the experimental group。Independent sample t-test before and after the experimental group and the control group intervention coronary heart disease knowledge score difference was statistically significant (P<0.05), and the knowledge of the experimental group score was greater than the control group。5. Repeated measuresanalysis of variance showed that main intervention effect on self-efficacy was significant(P<0.05), in other word, self-efficacy was significantly different between different interventions without taking account the change of time; the main time effect on self-efficacy was significant(P<0.05); there was significant interaction between time and intervention, and interaction diagram indicated that the increase degree of self-efficacy was higher in intervention group than that of control group over time after intervention。Paired t-test indicated that the experimental group and the control group, self-efficacy score equipartition (SE)、symptom management self-efficacy average (SE1)、before and after the disease common management self-efficacy average (SE2) intervention score were statistically significant(P<0.05), the control group score increased by less than the experimental group。Independent samples t-test indicated that self-efficacy score in the experimental group and a control group of patients before and after the intervention equipartition (SE)、symptom management self-efficacy average (SE1)、disease common management self-efficacy average (SE2) difference statistics significance (P<0.05), and the experimental group score was greater than the control group。6. Repeated measures analysis of variance showed that main intervention effect on depression was not significant(P>0.05), in other word,depression was not significantly different between different interventions without taking account the change of time; the main time effect on depression was significant(P<0.05); there was significant interaction between time and intervention, and interaction diagram indicated that the decrease degree of depression was higher in intervention group than that of control group over time after intervention。Paired t-test indicated that the level of depression in the experimental group and the control group scores were statistically significant (P<0.05), before and after the intervention and control group score lower magnitude smaller than the experimental group。Independent samples t-test indicated that depression horizontal difference was statistically significant (P<0.05) in the experimental group and a control group of patients before and after the intervention, a reduction greater than the control group and the experimental group scoreo7. Repeated measures analysis of variance showed, compared the level of the experimental group self-efficacy average comparison, for the patients in intervention group at T, To, T1and T3,the levels of the experimental group self-efficacy average comparison were siginificantly different。LSD-t pair wise comparison results were shown, the different time points of the experimental group self-efficacy average comparison, in addition to average with a sense of self-efficacy between each time point after the intervention before the intervention was statistically significant (P<0.05), average self-efficacy were not statistically significant (P>0.05) between the rest of the point in time; Different time points of the experimental group symptom management self-efficacy average comparison, in addition to a sense of self-efficacy intervention before and after the intervention between each time point after the intervention and one month after the intervention, as well as management of symptoms between one month and three months after the intervention the equipartition significant (P<0.05), the rest of the time between symptom management self-efficacy average were not statistically significant (P>0.05); Different time points of the experimental group of diseases common management self-efficacy average compared to before the intervention equally divided between the point in time after the intervention, the diseases common management self-efficacy were not statistically significant (P>0.05)。8. Repeated measures analysis of variance showed, compared the level of depression for the patients in intervention group at T, T0, T1and T3,the levels of depression were siginificantly different。LSD-t pair wise comparison results were shown, depression level comparison of the different time points of the experimental group, in addition to a significant level of depression between each time point after the intervention before the intervention (P<0.05), remaining at each time point between depression levels were not statistically significant (P>0.05)。Conclusions1. Patients with coronary heart disease have good cognition for incentives and risk factors of disease。2. The level of self-efficacy in patients with coronary heart disease is middle or low associated with age、cardiac function and the number of comorbidities。3. The high level of depression in patients with coronary heart disease associated with age、cardiac function and the number of comorbidities。4. Steering cardiac rehabilitation programme can significantly improve patients with coronary heart disease knowledge and self-efficacy and ease the patient’s depression。5. Cardiac rehabilitation programme builting for the purpose to improve the self-efficacy is safe、effective、spending less、high compliance and easying to promote。... |
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