Establishment And Effect Evaluation Of A Clinical Pathway Of Health Education For Patients Treated By Coronary Artery Stent Implantation

Objective: 1.To investigate the needs of health education for patients after coronary stent implantation and establish the health education pathway for them.2.To explore the intervention effect of health education pathway on the health knowledge,health belief and health behavior of the patients with coronary stent implantation.Methods: 1.Semi-structured interview is conducted to understand the needs of the 12 patients with stent implantation for health education knowledge so as to provide clinical data for designing health education pathway;2.Expert consultation method is applied to perfect the content of the health education pathway for the patient with stent implantation;3.Randomize 120 patients with coronary stent implantation in the Department of Cardiology of a grade one hospital in Chongqing,and then divide them into two groups: one is intervention group,the other is control group,with 60 people in each group.For the patients in intervention group,health education pathway is used to give health education to them,and for the patients in control group,they will receive routine health education.Then using health knowledge and health belief scale as well as self-management scale to compare the health knowledge,health beliefs and health behavior of those patients who have been discharged for three months in the two groups.4.Statistical software is used to perform the statistical analysis.Mean,standard deviation and composition ratio are adopted to describe the general information of the patients as well as the score on health education,health belief and self-management;meanwhile,variance analysis of factorial design was used to compare the differences between the two groups on the respective score on health knowledge and health belief,T test are used to compare the difference between the two groups on the respective score for self-management behavior as well as total score.The test level was P<0.05.Results: 1.Through the above mentioned semi-structured interview,we have drawn the following conclusion: 1.Patients with coronary stent implantation are lacking of knowledge about their disease;2.Health knowledge is urgently needed,especially basic knowledge about coronary heart disease,stent implantation related knowledge,daily life habits.3.The health knowledge of the patients mainly comes from the advertisements on newspaper and healthcare related TV program as well as from other patients.In hospital,related knowledge mainly comes from doctors.4.Few access is available for patients to get the health related information,and the health promotion behavior is not very effective.2.Through the expert consultation,the final health education pathway for the patients with stent implantation contains admission education(the first day of admission),preoperative education(1 days before operation)and postoperative Education(1 days after the day of surgery),rehabilitation education(2-3 days after operation),hospital discharge education(discharge day).Altogether there are 5 indicators in level 1 and 34 indicators in level 2.The expert questionnaire recovery rate is 100% and 95.65% respectively.Meanwhile,73.91% of the experts propose to make some change about the questionnaire in the first round,while 31.85% of the experts proposed to do the same in the second round.The authority coefficient for the experts of the two rounds is 0.925 and 0.935 respectively.After two rounds' consultation,coordination coefficient for the indicators of level 1 and level 2 is 0.124 and 0.220 respectively.3.After the clinical implementation of the health education pathway,the health knowledge and belief of the patients in the intervention group have improved,with the score for health knowledge increasing from 37.07±5.42 to 55.77±7.71,and the health belief from 14.10±2.48 to 18.90±2.06,the difference is reasonable when the discrepancy is below 0.05.After intervention,the scores of knowledge and beliefs in the intervention group were higher than those in the control group,the difference is reasonable when the discrepancy is below 0.05.For the patients who have discharged for three months,the score of the intervention group is 100.73±8.68,which is higher than the 91.13±10.70 get by the control group.In statistics,the difference is reasonable when the discrepancy is below 0.05.Conclusion: This study has developed health education pathway for patients with coronary stent implantation,which provides a scientific basis for us to give health education to patients with coronary heart disease.Compared with traditional health education,the health education pathway can improve the health knowledge,health belief and health behavior level of the patients with coronary heart disease.