| ObjectivesTo investigate the level of self-management ability of patients with coronary heart disease after percutaneous coronary intervention(PCI), analyze the correlation between the personal information of the basic situation, self-management behavior, and the personal basic information after percutaneous coronary intervention, and explore the factors which influenced the self-management capacity, and methods and ways which improved the self-management behavior of the patients with the PCI, establish the mode of self-management for the patients with PCI, and to study the effect of systematic and targeted health education and follow-up nursing intervention on the level of self-management ability and the quality of life of the patients.MethodsIn this study, we surveyed 148 patients with PCI in cardiovascular medicine of a certain top three hospital in province from June to December in 2014. The questionnaire was used to collect the patients’data, We analyzed the factors which influenced the self-management behavior of the patients.According to the ID number of the hospitalization, the patients were randomly divided into an intervention group (n=74) and a control group (n=74). The questionnaire was used to collect the patients’data, We analyzed the factors of the patients and established the self-management mode by consulting the literature and experts in the related field. Besides, we applied the systematic and targeted health education and follow-up nursing intervention for 3 months, after that we used the self-management scale, Seattle angina questionnaire to assess patients self-management data, quality of survival, and collected the patients’ recent physiological indicators. Finally, we observed the intervention effect by the differences between the two groups in self-management level, life quality, and physiological index from the very start and the post-intervention.Results1. The highest self-management ability score of the patients with percutaneous coronary intervention was up to 91 points, and the lowest was 50 points. The average score was (72.85±7.36) points. Of which,8 cases (5.4%) were lower than 60 points, and 25 cases (16.9%) were greater than 80 points. These results reflected the general patients’ self management ability was at a level below average.2. Of the scores in every dimension of the self management ability scale for the patients with PCI, the bad habits for management score was (13.54±2.95), the life management score was (11.66±2.63), the disease knowledge management score was (9.52±1.97), the symptom management score was (9.36±2.02), the treatment adherence management score was (8.57±1.87), the emergency management score was (9.48±2.49), and the emotional cognitive management score was (10.72±2.12) Bad habits management score was the highest in each dimension, and the treatment for compliance management score the lowest.3.By the single factor analysis of variance or two independent samplet-test method, we found that the factors which affected the self-management behavior were gender, education level, stenting experience, and whether with risk factors for diabetes and coronary heart disease. The differences were significant (P<0.05). In general, there was a significantly higher level of management of women than that of men, and the scores of the female for the bad habits, symptom management, compliance management, emergency management, emotional management were significantly higher than that of the male (P<0.05). The general management, compliance and emergency management scores of patients with higher degree were higher than that of patients with lower degree. (P< 0.05). Re-PCI patients in general were higher in compliance management score than the patients with first PCI. (P< 0.05). The patients with the diabetes mellitus and hypertension scored better in bad habits management than those who with no complication did (P< 0.05).4. Indicators compared between the intervention group and the control group after intervention:After systematic and targeted health education and follow-up nursing intervention for 3 months, the 7 dimensions of the self-management ability and the 5 dimensions of the quality of life scale score in the intervention group were significantly different from that in the control group. The blood lipids, blood pressure and glucose levels were improved significantly in the intervention group, and the management of smoke and alcohol was also improved. The differences between the two groups were statistically significant (P<0.05).ConclusionThe self-management ability of PCI patients as a whole was in the partial middle level. The bad habits management was the best, and female patients were better than the male patients, patients with complications were better than those with no complications. The treatment compliance management score was the lowest, especially in cultural level, male patients, and the first line of PCI patients. Systematic and targeted health education and follow-up nursing intervention after 3 months can improve the self-management ability, health behavior and the quality of survival of PCI patients. |
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