Application Of Collaborative Nursing Model Based On Trans-theoretical In Cardiac Rehabilitation Of Elderly With Coronary Heart Disease

ObjectiveThe aim of this study was to explore the effect of the model of collaborative care based on trans-theoretical on the quality of life,self-efficacy,physical fitness and clinical changes of elderly patients with coronary heart disease(CHD)and to evaluate the effect of intervention on heart rehabilitation in elderly patients with coronary heart disease,and to provide a reference for further development and improvement of cardiac rehabilitation program.MethodsIn this study,elderly patients with coronary heart disease who underwent hospitalization in Qingdao from December 2015 to June 2016 were selected according to the order of admission time.The odds were control group,even for the intervention group.In the control group,patients were treated with routine nursing measures.The intervention group was treated with a collaborative care based on the Tran-theoretical model.Nursing interventions corresponding to the behavioral changes were given to the patients according to the developed cardiac rehabilitation program.Two groups were collected information at before discharge,3 months and 6 months after discharge.The data included general information,CQQC scale,self-efficacy scale,six-minute walking test,behavioral change stage assessment scale and Borg scale,and by measuring the elderly patients with physical fitness and physiological indicators of the level of change to evaluate the effect of intervention.Results1 the results of this study showed that the self-efficacy of elderly patients with coronary heart disease improved significantly after intervention(t=-7.097,P<0.05),the difference was statistically significant.The scores of the four dimensions of CQQC in general condition,general life,social psychology and work were significantly increased after intervention(P<0.05).2 The number of patients in the group was significantly higher than that in the control group(P<0.05),and the proportion of the patients during the operation and main-Tenance phase after 6 months of intervention was 45.1% and 29.4% respectively.3 The proportion of the control group was 18.9% and 15.1%(P<0.05),while the patient's Exercise endurance,upper limb muscle strength,lower limb muscle strength and body flexibility improved significantly,Repeated variance analysis showed that there was interaction effect(P<0.05),but patients with upper limb flexibility,lower limb flexibility improvement effect is not obvious(P>0.05).In the physiological indexes after intervention,the analysis of repeated variance showed that there was interaction between BMI,total cholesterol,systolic blood pressure,diastolic blood pressure,The improvement of the intervention group was statistically significant(P<0.05).4 In the patients' lifestyle comparison,the smoking rate of the intervention group was lower than that of the control group at 3 months and 6 months after the intervention,the difference was statistically significant(P<0.05).In the number of smoking,The intervention group was significantly improved at each time point after intervention,There were significant differences in the frequency of exercise between the two groups(P<0.05)at 3 months and 6 months after intervention.The exercise of the intervention group was significantly improved compared with the control group,Patients with good exercise compliance.Conclusion1 The intervention of Collaborative nursing model based on TTM and routine nursing intervention can help improve the quality of life of elderly patients with coronary heart disease,the general self-efficacy;2 The intervention of Collaborative nursing model based on TTM is to ensure the treatment compliance of elderly patients with coronary heart disease,and improve the patient's physical fitness and physiological indicators;3 The intervention of Collaborative nursing model based on TTM is to enhance the confidence of patients over the disease,improve the elderly patients with coronary heart disease self-management capacity and disease response capacity,and promote the rehabilitation of patients.4 The intervention of Collaborative nursing model based on TTM is superior to the traditional routine mission and nursing,it is worth further adherence and improve.