| Objective1 To describe illness perception, social support and self-management behavior of patients with coronary heart disease after percutaneous coronary intervention.2 To analyze the influencing factors of self-management behavior of patients with coronary heart disease after percutaneous coronary intervention.3 To investigate the pathways of illness perception, social support and self-management behavior of patients with coronary heart disease after percutaneous coronary intervention. MethodsThis was a cross-sectional descriptive study. By convenient sampling, 203 cases of coronary heart disease patients after percutaneous coronary intervention were selected from Department of Cardiology of the First Central Hospital in Tianjin. The survey was conducted through the issuance of self-designed questionnaire, the revised illness perception questionnaire(IPQ-R), perceived social support scale(PSSS), and coronary heart disease self-management behavior scale(CSMS). Statistical software SPSS17.0 and AMOS21.0 were carried on to analyze the data, including statistical description, correlation analysis and multiple regression analysis, path analysis was applied to investigate the pathways of illness perception, social support and self-management behavior. Results1 220 questionnaires were issued, and 203 cases were effective, the recovery rate was 100%, and the effective rate was 92.27%. The age of the 203 participates ranged from 48 to 77 years old, the average age was 61.59±6.69 years old; including male patients 105 cases, accounting for 51.72%, and female patients 98 cases, accounting for 48.28%.2 As for symptom identification, 17.2% of the patients could recognize two symptoms, 67.98% of the patients could recognize three symptoms, and 14.78% of the patients could recognize four symptoms; the top three of the most recognized symptoms were chest pain(68.47%), chest discomfort(58.62%) and cold sweat(40.89%). The average scores of each dimension of illness and self perception were as follows: recurrence(cyclic) 2.58±0.56 points, course of disease(acute/chronic) 3.84±0.54 points, illness coherence 2.50±0.63 points, confidence of treatment 3.16±0.50 points, self control 2.69±0.60 points, consequences 3.44±0.56 points, emotional statement 3.19±0.44. Causes of disease after factor analysis, ranking from high to low were as follows: physiological factors 3.69±0.39 points, behavioral factors 3.08±0.52 points, environmental factors 3.03±0.78 points, psychological factors 2.83±0.27 points, gene and accidental factors 216±0.42 points, immune factors 2.09±0.34 points.3 The total score of social support was 42.00±2.84 points, the support from family was 20.83± 2.73 points, and from others was 21.17±1.95 points.4 The total score of self-management behavior was 75.26±12.60 points, the score index was 55.75%. The scores of each dimension of self-management behavior ranking from high to low were as follows: habits management(86.23%), emergency management(73.83%), general life management(65.86%), therapy compliance management(53.53), disease knowledge management(43.27%), emotional and cognitive management(39.38%), symptom management(35.25%).5 Patients with characteristics of: 60-70 years old, education of college and above, family income more than 2000 yuan, living together with spouses, course of coronary heart disease was more than 3 years, had a history of acute myocardial infarction, numbers of combined other chronic disease were two or above, had better self-management behavior, the difference was statistically significant(P<0.05).6 There were correlations among illness perception, social support and self-management behavior(P<0.05).7 Education level, self control, behavioral factors, course of disease(acute/chronic), consequences, and social support entered into the regression equation, accounted for 27.6% of the total variation of the equation.8 Illness perception played an intermediary role in the relationships of the three variables, social support affected self-management behavior completely through illness perception, the mediating effect was 0.79*0.65=0.51. Conclusion1 Illness perception of patients with coronary heart disease after percutaneous coronary intervention should be strengthened, and social support mainly came from family, the level of self-management behavior was not ideal.2 Education level, self control, behavioral factors, course of disease(acute/chronic), consequences, and social support were mainly influencing factors of self-management behavior, suggesting that medical personnel should give full consideration to psychological and social factors in the self-management behavior intervention process and conduct interventions according to patient's education level, illness perception characteristics, social support, in order to effectively improve self-management behavior.3 Social support affect self-management behavior completely through illness perception, suggesting that medical personnel could improve patient's illness perception through strengthening social support, so as to promote self-management behavior. |
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