Health Belief Model:A Novel Nursing Model For Improving Anticoagulation Management Within Cardiac Mechanic Valve Replacement Patients

Objective:To explore the role of nursing intervention strategy adopted under the guidance of the Health Belief Model in the anticoagulation management of cardiac valve replacement patients,to explore its impact on postoperative belief about medicine specific to warfarin, adherence to anticoagulation therapy and the incidence of anticoagulation-related complications,to establish the protocol of Health Belief Model guided nursing strategy of postoperative anticoagulation management.Method:During Jan 2014 to Sep 2014,120 patients were included in this study from cardiovascular surgery department of 2nd affiliated hospital of Nanjing Medical university.Randomly assigned to 2 groups:observation(Routine nursing group) and experiment (HBM,Health Belief Model group), each 60 patients. There were no statistically significant difference between groups in gender,age,education,ethnic or type of surgery,concomitant diseases, etc. Both groups were examined with telephone survey at 3 time points:discharge,3 months after discharge and 6 months after discharge,and the questionnaire contains some parts listed below:the general information questionnaire,Knowledge of Anticoagulation with WarfarinQuestionnaire,Beliefs about Medicines Questionnaire specific to warfarin (BMQ-Specific),the Chinese Revised 8 Item Morisky Medication Adherence Scale (MMAS-8), and the incidence of anticoagulation-related complications,etc. All these date were recorded in excel 2007 and analyzed in SPSS 13.0 software.Results:with time after discharge,both groups had elevated questionnaire scores of Knowledge of Anticoagulation with WarfarinQuestionnaire,but no statistically significant difference;Routine group had declined questionnaire scores in Beliefs about Medicines Questionnaire specific to warfarin (BMQ-Specific) and the Chinese Revised 8 Items Morisky Medication Adherence Scale (MMAS-8),on the contrary,HBM group experienced elevated scores,significant differences was found between the two.HBM group has a lower incidence of anticoagulation-related complications.Conclusions:Compared to Routine group, HBM group had obvious advantage in aspects such as awareness of knowledge of anticoagulation, Beliefs about medicine and adherence to anticoagulation therapy.HBM guided nursing intervention strategy could effectively improve the health belief of cardiac valve replacement patients, and lower the incidence of anticoagulation-related complications.