| Background For human kind as a compound of physiology, psychology and society, psychological problems become more and more concerned with the transformation of medical mode. Nursing jobs expanded from taking care of daily life and desease of patients to fulfilling of overall physiological, psychological and social necessicities of them. Acute Myocardical Infarction (AMI) is caused by myocardial necrosis due to serious and permanent ischemia, which results from sharply reduction or termination of blood supply in arteria coronaria. It is a kind of serious coronary heart desease due to its seriousness, repidness and multi-complication. AMI patients bear huge psychological pressure and sophisticated psychological reactions, for instance anxiety, depression, tension and fear etc. The generation of psychological pressure correlates with occurance of negative sentiments and recurrence of desease, prognosis, and living standard of the patients. It was found that various stress management solutions were able to relieve various sendimental and physiological disabilities, including AMI. However, research on stress management on AMI patients was not found domestically. In this paper, stress management on AMI patients, impacts on anxiety, depression and life quality of AMI patients in various desease stages are studied for the first time. Objective Stress perception among acute myocardial infarction (AMI) patients during active period was explored. The effects of Stress Management on AMI patients when they discharge and 3 months after discharge were examined.Methods Phenomenological method of qualitative study was adopted.18 AMI patients in the hospital were interviewed when 3-4 days after the onset of the disease. Phenomenological method was adopted to analyse the data. 326 initial AMI patients were collected from a CCU in a hospital in Shanghai in terms of time. There were 156 samples in the control group and 170 samples in the experimental group. Gender, age, marriage, education, professional background, disease situation, anxiety and depression scores before stress management had no statistical significance (p>0.05). Therefore both groups were comparable. Usual care and seminars were provided to both groups during hospitalization and after discharge. Based on that, stress management was provided to experimental group during hospitalization and after discharge. Hospital Anxiety and Depression Scale (HADS) and Seattle Angina Questionnaire (SAQ) survey were adopted during the hospitalization and 3 months afterward. Various statistical examinations were adopted to analyse the variation and trend of the indicators.Results Qualitative Research:Stress brought initial AMI patients various pressure experiences. For inatance, they found it hard to accept the fact of illness and worry about the treatment effect and the impact on future life, and it was hard to alter living habits and relieve negative emotion. Quantitative Research:Among the 156 patients, the incidence of anxiety was 31.4% and depression was 41.6%. Patients’education background, profession, age, average income, medical fee sources, household care, marriage, co-inhabitants, complication and range of AMI parts were found to affect HADS scores at different stage of AMI. It is also found that stress management based on Omaha System is able to relieve anxiety and depression sentiment during acute stage, discharge and post-MI period of the AMI patients and improve their life quality during discharge and post-MI. The anxiety scores of AMI patients in the control group are 29% within 100 patients during hospitalization,38% when discharge and 44% during post-MI. The depression scores are 40% during hospitalization,50% when discharge and 53% during post-MI. The anxiety and depression scores vary and rise gradually in the acute stage during hospitalization, when discharge and during post-MI (p<0.0001). For the 100 patients in the experimental group, the positive rate of anxiety before experimental in the acute stage during hospitalization is 37%. After experimental, the score is 20% when discharge and 4% during post-MI. The depression scores are 41%,35% and 11% respectively. The anxiety and depression scores vary and drop gradually in the 3 stages (p<0.0001). The anxiety and depression scores of the experimental group when discharge and during post-MI are lower than those of the control group (p<0.01; p<0.0001). The AS of control group performed better in post-MI than during hospitalization. The TS and DP lower than those during hospitalization and other parameters remained same. Significant discrepancies were obvious in the main outcomes when the experimental al group was compared with the control group at different stages.Conclusion Initial AMI patients during active period experienced different levels of psychological stress. The incidence of anxiety and depression were high. The incidence of anxiety and depression dropped and life quality of AMI patients can be improved by tailored, systematic and on-going stress management. |
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