Study On Impact Of Protection Motivation Theory On Patients’ Self-management Behavior After Coronary Stent Implantation

Objectives:To discuss the effects comprehensive nursing interventions based on protection motivation theory on self-management behavior, self-efficacy and physiological indexs of patients after coronary stent implantation, clarify the concrete implementation means of the comprehensive nursing intervention of protection motivation theory, improve the self-management level of the patients after coronary stent, slow down the disease, improve prognosis, reduce the patients’medical costs, eventually raise the quality of life.Methods:100 hospitalized patients were selected as research models who were diagnosed with coronary heart disease (CHD) by coronary angiography and accepted coronary stents in cardiology center of a Grade-Ⅲ A Hospital of Changchun during March 2015. According to the method of random number table,100 patients were divided into experimental group of 49 cases and control group of 51 cases. Two groups of patients were given conventional perioperative nursing intervention. Meanwhile, the experimental group received comprehensive caring intervention based on PMT for six months. Develop targeted interventions mainly from the formation of the protection motivation threat assessment (severity, susceptibility, internal and external return return) and response assessment (reaction efficiency, self-efficacy, and cost) of the seven variables. The Coronary artery disease Self Management Scale (CSMS), General Self-Efficacy Scale (GSES) and physiological indexes were used to evaluate the self management level of the patients in both two groups before intervention,3 months after intervention and 6 months after intervention. The self-management behavior, self-efficacy and physiological indexes were compared between two groups of patients before and after the intervention.Results:1. In the two groups,5 cases were losed in the control group,4 cases in the experimental group, finally 91 cases completed the follow-up. There were no differences with statically significance between baseline data including age, gender, educational level, occupation, marital status, medical payment, economy, condition and so on (P> 0.05), baseline data comparable.2. Compare the self management behavior and self-efficacy between the experimental group and control group:the self management behavior score, daily management, medical management and self-efficacy scores of the experimental group after intervention for 3 months and 6 months were significantly improved comparing with that before intervention, and the differences were statistically significant (P< 0.05). The differences continued to exist between 6 months and 3 months after intervention (P< 0.05). The self-management behavior score, daily management, medical management and self-efficacy scores of the experimental group after intervention for 3 months and 6 months were higher than those of the control group, and the differences were statistically significant (P< 0.05).3. Compare the blood pressure, blood sugar and blood lipid level between the experimental group and control group:the various physiological indexes (except LDL and TG) of the experimental group after intervention for 3 months and 6 months were obviously improved comparing with that before intervention, and the differences was statistically significant (P< 0.05). The differences continued to exist between 6 months and 3 months after intervention (P< 0.05). There were statistical differences in the change of SBP, DBP, TC, HDL between two groups after intervention for 3 months (P< 0.05). There were statistical differences in the change of various physiological indexes (except LDL and TG) between two groups after intervention for 6 months (P< 0.05).Conclusions:l.The comprehensive nursing intervention based on protection motivation theory can improve the patients’SBP, DBP, FBG, Hb Alc, TC, HDL, but the improvement of LDL and TG is not significant.2.The self-management behavior score, daily management, medical management and self-efficacy scores of the patients in experimental group after intervention were significantly improved, but the improvement of emotion management was not obvious.3.The comprehensive nursing intervention based on protection motivation theory can promote self management behavior of the patients.