Development And Application Of Self-management Scale For Patients Undergone Coronary Artery Stent Implantation

ObjectiveTo develop a self-management scale for patients undergone coronary artery stent implantation, evaluate its reliability and validity through qualitative and quantitative tests; To investigate the self-management status and analysis the relevant factors in patients after coronary stent implantation in order to provide the evidence for more individual health education and health promotion intervention.Method1. The item pool with 30 items was developed based on the chronic disease self-management scale, the coronary artery disease self-management scale developed by Ren Hongyan in 2009 and China Percutaneous Coronary intervention Treatment Guidelines 2012. Firstly,20 patients were semi-structured interviewed and the primary scale was evaluated by 7 specialists,2 item were deleted with 28 items left2.230 patients after coronary stent implantation were recruited from a general hospital in Shandong province. Based on the data collection the series of statistic analysis were conducted such as factor analysis, correlation analysis etc. Three more items were deleted with 25 items left. The final version of self-management scale for patients undergone coronary artery stent implantation was developed with 25 items 5 subscales.3.310 patients after coronary stent implantation were recruited for the formal survey from a general hospital in Shandong province. The general information and the self-management related factors were also collected.Results1. The self-management scale for patients after coronary stent implantation was developed with 5 subscales 25 items included.2. The item-level content validity index was 0.857-1, and the scale-level content validity index was 0.933.3. The pre-survey results indicated the internal consistent reliability index of the scale was 0.881, the item reliability index was 0.656-0.860, the split-half reliability index was 0.866/0.733; In the formal survey, the internal consistent reliability a index of the scale was 0.883, the item reliability index was 0.664-0.863, the split-half reliability index was 0.894/0.771.4. The mean score of self-management of the patients after coronary stent implantation was mean (55.21±12.23). The scores of the subscales transferred to 100 mark system were:daily healthcare knowledge (70.48±11.60), emotion management(60.58±14.78), compliance behavior(57.49±12.35), disease knowledge(50.83±12.95), emergency skill (50.83±12.95). The healthcare knowledge was given by (from high to low):doctors (73.3%), nurses (58.9%), mass media(47.1%), friends(41.2%). The factors handicapped the self-management was:shortage of self-management knowledge (81.8%), financial problem(29.1%), lack of necessary support(24.8%). By the single—factor analysis, the impact of age, gender, occupation, income, medical insurance type, prevalence period on self-management level after CSI was statistically significant.Conclusion 1. The reliability and validity of the self-management scale for patient after CASI was tested credible. It is suitable to evaluate the patients’ self-management status after CASI2. The self-management level of the patients after coronary stent implantation was not as good as the author expected. The scores of the subscales from high to low were:daily healthcare knowledge, emotion management, compliance behavior, disease knowledge, emergency skill.3. The factors such as age, occupation, monthly income, medical insurance type, lasting of disease were related with patient’s self-management level.4. Health related knowledge was mostly from doctors, and then nurses, the last were mass media and friends.5. The factors discouraging the self-management chosen by patients mostly was shortage of knowledge, secondly was financial problems, and then lack of necessary support and help.